Description: Discussion of the impact of the ACA on RBS and required surplus for a health plan

Description: Remain a competitor in health insurance with value, knowing the competition, and using external experts Issue No. 37.

Description: Current Status of managing costs & increasing costs, Future Direction of Consumerism, technology and defined contribution health plans. Issue No. 39.

Description: This article will consider several issues arising from ACO budgeting and pricing of stoploss coverage, including: 1) attribution of members; 2) claim carve outs; 3) ambiguous stoploss terms; 4) providers gaming the system and 5) credibility of data.

Description: An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two fields.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

Description: Review of a research project, co-sponsored by the SOA, which examined 83 organizations and over 150 programs that measure the quality and efficiency of hospitals and physicians.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

Description: This article compares July 1 renewal premium trends to January 1 renewal premium trends by benefit plan.

Description: A new initiative, Commercial Health Care: What’s Next, will focus on education and research for health actuaries regarding issues that remain with the ACA.