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: 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: Recently, the SCAN Foundation, AARP, LeadingAge, and HHS funded economic modeling conducted by Milliman and the Urban Institute around LTC reform elements. The LTC industry has over the years also generated ideas to address the on-coming expansion of LTC needs in the U.S. For this article, we have brought together three individuals who have long involvement with LTC financing to discuss some of the recent ideas and provide some perspectives on their pluses and minuses.

Description: The article explores the lack of focus of Social Security reform proposals on the the next twenty years and the imminent drawing down of the Social Security Trust Fund sometime near the end of that period.

Description: Article that discusses the structure of and concern for using social security numbers as a means of identification.

Description: This session is about the details of the inception and implementation of the Oregon Health Plan. From Record of Society of Actuaries Vol. 18, No. 1B.