Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: Research report sponsored by SOA to model and compare projected costs of different proposals for a Medicare prescription drug coverage plan. 3 types of costs are studied: net benefit cost estimates per member per month, continuance table data, and projected annual costs to the government over 10 years for two selected plan designs.

Description: Report on the activities of the Academy’s health practice council and its work groups.

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.

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: Panel discussion of prospects for cost containment of, and alternatives to, fee-for-service health care, and management of health care under national health insurance. Discussion points include cost containment devices, HMOs, economic impact, cost escalation, self-insurance, stop-loss, claims administration, loss of state premium taxes, and Phase 3 tax problems under NH1.

Description: Panel discussion focusing on managing health care costs.

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.