Description: Reviews the book, HMOs and the Politics of Health System Reform, by Joseph Falkson which discusses HMOs' legislative and regulatory structuring.

Description: This article, an Honorable Mention Essay for the Society of Actuaries' Entrepreneurial Actuaries Section 2010 Papers Competition, is a discussion of the various issues relating to measurement of data in healthcare. The author presents “a light hearted & tongue-in-cheek take on how healthcare is typically measured, and an entrepreneurial vision for a better world.” Noting that typically data is summarized in deterministic models that produce point estimates for analysis and decision making, the author’s vision presented in the paper “is that of a central repository of actuarially modeled distributions that can either be used as benchmarks or adapted to an organization's experience.”

Description: This article describes the Health Insurance Providers Fee implemented through Section 9010 of the Affordable Care Act (ACA) and discusses how the fee will creates challenges in Managed Medicaid Rate development. It also offers some suggested ways to include the fee in Managed Medicaid rates.

Description: This essay, submitted for the Society of Actuaries' Entrepreneurial Actuaries Section 2010 Papers Competition, proposes an entrepreneurial solution to address the continued, unsustainable increases in health care costs. Under the author’s plan, entrepreneurs will “develop systems providing clear financial motivation for consumers to make decisions that minimize health care spending and maximize positive health outcomes. In so doing, health care providers must necessarily compete to offer the highest quality services at the lowest cost. By relying on the financial self-interest of consumers and free-market competition among health care providers, effective and sustainable systems to bend the health care cost curve can be achieved.”