Description: Review of a research project, co-sponsored by the SOA, which examined 83 organizations and over 150 programs that measure the quality and efficiency of hospitals and physicians.

Description: This article provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: Summary of the health section council’s research project to assess the accuracy of commonly used IBNR estimation methods over a wide range of scenarios.

Description: This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness.

Description: Shannon Brownlee shares her perspectives on the current health care crisis, including: inconsistent treatment patterns across providers and geographic regions, providers lacking evidence-based guidelines, the need for better independent clinical research to establish those guidelines, and the limits to consumerism's potential to fix the crisis.

Description: A rethinking of current provider reimbursement, focusing on incentives instead of simply cutting fees. The recommended 2-pronged approach would feature integrated provider organizations as well as evidence-based decision making organized around episodes of care.

Description: As private payers ponders the early adoption of genomic testing to guide treatment pathways, can personalized approaches to care prove financially sound?

Description: This article summarizes some of the operational considerations necessary to optimize the usefulness and impact of a predictive model, such as cross-functional support and involvement in model build, adequate training and reporting, and strategic model build.