Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: The author describes how his company was able to benefit from an application of risk theory.

Description: A new health insurance pricing model takes external market prices into account, as well as regulatory rate restrictions and other traditional pricing factors. Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral & loss ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has a healthier than average mix of risks.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: Discussion of the separate and joint effects of obesity and diabetes on disability and mortality, and ways these effects can be used to improved insurance pricing and reserving, reverse the increasing rates of obesity and diabetes, and improve current projections of disability and mortality risks.

Description: An overview of the formation of the Committee of Professional Associations on Federal Statistics, initiated by the Joint Ad Hoc Committee on Government Statistics, in response to the need for statistical advisory committees to government agencies to promote better data collection and dissemination, contracting, forms clearance, planning, coordination, monitoring, staffing, and strengthening of agency functions.

Description: A recent Society of Actuaries study calculates safety and stability for current Long Term Care Insurance premiums.

Description: An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures.

Description: A study of disability experience examines cost burden and degree of disability, and how these measures vary across different subpopulations. This article summarizes a presentation given at the Society of Actuaries’ Living to 100: Survival to Advanced Ages International Symposium held on Jan. 7–9, 2008 in Orlando, Florida. An abstract of the author's paper was presented in the September 2008 issue of Long-Term Care News.