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: The National Association of Insurance Commissioners (NAIC) is moving forward to implement a new regulatory requirement that requires U.S. insurers to perform an Own Risk and Solvency Assessment (ORSA). Before developing a response to the ORSA requirement, insurers will want to understand its genesis and the underlying rationale for it, as well as its implications. This essay provides an overview of the evolution and rationale for ORSA, as well as practical implications for insurers as they begin to design an ORSA process. Part of the essay collection "Risk Metrics for Decision Making and ORSA"

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: 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: Current Chairperson, Vincent Bodnar, provides a section update and outlines the need for innovative solutions to current LTCI concerns.

Description: A discussion about the section’s accomplishments including research activities, professional development and benefits of being a member of the section.

Description: Insurers are becoming increasingly involved in the development and marketing of prepaid health care service plans, or Health Maintenance Organizations HMOs. The article describes four different approaches for establishing capitation rates for HMOs 1. Integrated Budgeting Approach, 2. Inventory Approach, 3. Group Insurance Rating, and 4. Actuarial Approach.

Description: Defines Accelerated Underwriting programs as a transformational trend, and outlines a process for evaluating mortality implications of such programs.

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.