Description: Description and specifications for the health section's article-writing contest on the topic of provider payment reform.

Description: Panel discussion focusing on managing health care costs.

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: 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: 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: This actuarial memorandum represents the first, formal actuarial opinion regarding the reasonableness of the premium estimates the Clinton Administration presented with its proposed Health Security Act. The memorandum presents the assumptions and methods used to develop an average 1994 premium estimate for the standard benefit package.

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

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: Discussion of possible national health care reform measures, including coverage for the unemployed, employer-mandated plans, publicly funded and administrated plans. Also an overview of recently enacted legislation at both the state and federal level, and measures taken by provider organizations, for controlling costs.. Presented at the Spring 1975 Meeting in New York.

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