Description: Review of a research project, co-sponsored by the SOA, which examined 83 organizations and over 150 programs that measure the quality and efficiency of hospitals and physicians.

Description: Part II of a two-part series discussing individual market evolution from before the ACA through President Trump's first term.

Description: An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two fields.

Description: Remain a competitor in health insurance with value, knowing the competition, and using external experts Issue No. 37.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

Description: This article provides an overview of the Own Risk and Solvency Assessment (ORSA) model act, and of enterprise risk management (ERM). Compared to other actuarial disciplines, health actuaries have not historically focused as much on ERM. But health coverages do have risks that can threaten an insurer's solvency, and ORSA (now in force in most states) will force health insurers to beef up their ERM capabilities.

Description: Current Status of managing costs & increasing costs, Future Direction of Consumerism, technology and defined contribution health plans. Issue No. 39.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

Description: Excerpts from a conversation with Alan Mills regarding his work in complexity science and agent-based modeling.

Description: In this article, the author discusses the considerations and advantages of implementing an integrated enterprise risk management program for a health insurance company, and presents a summary of Aetna's experience with ERM as a case study.