Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

Description: sources of Health Care data Issue No. 37.

Description: Realizing the impact of medical errors on the U.S. health care system, the Health Section commissioned a research project to measure the annual frequency of medical errors and their total measurable direct and indirect cost to the economy.

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

Description: An announcement of the roster of the newly reconvened Health Section Research Committee, and an invitation to propose, participate in, and read about the committee's projects. informal RFP to solicit research project ideas, invitationto join project oversight groups and

Description: This article provides an overview of critical illness insurance: history, product description, and the three primary ways to offer critical illness coverage in the United States. This article also contains an illustration of an issue age premium rate calculation, as well as product features and rating applications specific to the various types of critical illness coverage.

Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

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

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate and influence health care policymakers on issues including principles for health care reform, Medicare, wellness programs, and solvency.

Description: A preview of the contents of the latest issue, including essays & interviews related to health care reform, provider reimbursements, rate filing review, and medical errors.