Description: The article is a case study of various actuarial concepts invovled in the design and implementtion of the AQC - a global budget provider payment arrangement implemented by Blue Cross Blue Shield of MA.

Description: The article reviews high-deductible health plans and poor reimbursement for mental health providers as being the root of 3 devastating problems facing the US.

Description: An analysis of the 1999-2011 experience of all Blues plans of betweeen $1.8 and $3.8 billion in annual revenue in 2010 to determine if there is any empirical evidence of an industry underwriting cycle. The analysis shows there is no such evidence.

Description: This article examines the history, theory, and effectiveness of high-deductible health plans and health savings accounts.

Description: What you need to know about risk scores to be competitive in the Medicare Advantage market.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

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: Article compares HMOs to other one stop non-health corporations that have gone away and states still in existance only due to forced government regulation, Issue No. 39.