Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: This is an abstract for the paper, Analysis of Costs for a Chronic Disease with Acute High Cost Episodes by Marjorie Rosenberg and Philip Farrell.

Description: Presented at Living to 100 Symposium, January 2011. This paper first explores the current state and contributing causes of obesity. It then explores the mortality and health care costs of obesity. It ends with a discussion of its management.

Description: Presented at Living to 100 Symposium, January 2011. This article estimates the impact of obesity and diabetes on disability and mortality for those older than 65 using the 2004 National Long Term Care Survey with disability based on the Health Insurance Accountability and Portability Act's Activities of Daily Living and Cognitive Impairment triggers.

Description: This session is about health risk adjusters and includes a discussion on risk assessment, actuarial applications, New York small-group reform, medical management applications, Rand 36, and other methods. From Record of Society of Actuaries Vol. 19, No. 4B.

Description: Presented at Living to 100 symposium January 2002. This paper evaluates age and sex specific patterns of change in underlying and multiple cause of death reports for the period 1980-1998 for 14 leading causes of death at ages 65 and older. Changes in four types of mortality measures will be analyzed: 1 underlying cause death rates 2 multiple cause death rates 3 associated cause death rates and 4 death rates based on the joint occurrences of multiple cause conditions. Implications of the results are discussed in the context of existing models for analyzing and forecasting future mortality patterns in the U.S.

Description: Discusses types and methods of analysis of morbidity experience, reserves, and policy form drafting issues.

Description: This session discusses the benefits of actuarial involvement in understand. Topics include current methods [such as teleunderwriting, use of pharmacy data] and the benefit versus cost of using various underwriting tools. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 22

Description: This article is illustrates the implications of the managed care organization MCO risk based capital RBC formula adopted by NAIC and compares it to the health organization risk based capital HORBC formula. From The Actuary, Nov 1997, Vol. 31, Issue 9

Description: In this paper, fuzzy sets - collections of objects whose boundaries are not precisely defined - are used to model the selection process in group health insurance. Both single and multiple options plans are discussed. Discussions of this paper are included.