Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: Digests of following discussions: 1. Mutual life insurance companies - their objectives and operating philosophy 2. State, provincial, and municipal employee pension plans - financing and other problems 3. Mortality and underwriting of individual policies for large amounts 4. Investing during the 1970's 5. Long-range viability and regulation of corporate pension plans 6. Forecasting the environment for business 7. Liabilities and surplus in the 1970's 8. Changing modes of family life - work and income over the life cycle 9. The role of the actuary in collective bargaining 10. Health insurance in the United States 11. Adjusted earnings

Description: The underlying premise of this paper is that enterprise risk management (ERM), as it continues to evolve as both a process and a collection of risk management techniques, can benefit from several different (but ultimately somewhat related) “megatrends.” The core of this paper concentrates on the impact on ERM of one of those megatrends: the emergence of a behavioral economics perspective, which is beginning to have a large impact on our understanding of the economy and on certain economic and business processes. The evolution and context of behavioral economics are described, and potential implications for the practice of ERM are discussed. The paper culminates with a variety of specific suggestions for ERM practice in response to findings from behavioral economics research, specifically a number of human cognitive dissonances inconsistent with traditional economic theory.

Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: Diverse Risks 2016 Call for Essays

Description: Using basic actuarial principles to develop a reasonable spending budget and to keep spending/savings on track to meet financial objectives.

Description: Nonprofit ideas shares lessons from the field about how a better understanding of underserved consumers can lead to better product design.