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: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.

Description: This article is a brief overview of what the Health Actuarial Research Initiative, HARI, is and what the participants in HARI will be doing. HARI is a project formed by the Society of Actuaries that will develop actuarial research studying changes in health care systems.

Description: The SOA’s recent work related to public policy research and an update on the General Insurance track.

Description: The Health Section chairperson discusses the past year's activity, especially the Visions for the Future of the U.S. Health Care System essay contest, and an update on the Untapped Opportunities for Actuaries in Health initiative.

Description: Rhode Island’s unique “global Medicaid waiver” pursues a potentially dangerous national policy trend: long-term care LTC rebalancing without strong eligibility controls. Resulting cost overruns could seriously damage the state’s social safety net. To maximize the global waiver’s opportunity, minimize its danger, and become a LTC financing model for the country, policy makers need to recognize the issues discussed in this report and pursue the recommended additional research and analysis.

Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to conduct research and educate health care policymakers on issues including principles for market reform, individual insurance, and risk factors.

Description: This article focuses on retirement decisions, phased retirement and related policy issues, calling for actuaries to take on leadership roles in retirement public discussion.