Description: Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will Republican health care reform look like?

Description: Conditions and required solvency standards of federal waiver to PSOs to provide Medicare+Choice products. Effect on providers, beneficiaries and employers. Issue No. 36

Description: This article discusses future benchmarks of Medicare and Medicare's rising costs and its relativity to the actuarial profession.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including principles for reform, Medicare, the individual insurance market, and risk factors.

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: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: An overview of the Medicare Supplement landscape and the critical factors for successfully pricing and managing this product line amidst the challenges that exist.

Description: This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.

Description: Changes in CMS requirements for 2011 Medicare Part D plans aimed at reducing confusion surrounding the PDP selection process by making plan differences more visible to seniors. Carriers have responded by making the most significant changes in plan offerings since the program's inception, which is expected to result in membership shifts.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.