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: Implications of Consumer-Driven Health Care to consumers, employers and providers Issue No. 37.

Description: Diagnostic coding in dental is in its infancy. This article explores the use of medical diagnostic coding and how it may transform dental care in various ways.

Description: Many executives are talking about predictive analytics uses in health insurance.

Description: This article contains a condensed summary and excerpt from the fourth white paper in the Commercial Health Care: What’s Next? series.

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 provides a detailed description of the unbalanced subsidy provisions in the Affordable Care Act with easy to follow numerical illustrations. An understanding of the illustrative calculations is necessary to understand the subsidy implications. The article highlights some surprising and likely unintended results that will be interest to issuers, employers, consumers, regulators and policymakers. Actuaries can add expertise to their clients and to the public discussion with a proper understanding of the subsidy calculations and the resulting implications.

Description: This article discusses the challenges and unknowns relating to the regulatory inclusion of pediatric dental benefits within the essential benefits list of the Affordable Care Act (ACA).

Description: Summary and analysis of the diseases and conditions exhibited in the Medicare Advantage population

Description: Who Is to Blame for Cost Increases? by Dinkar Koppikar from Health Section News, October 2004, Issue No. 48.