Description: Description and specifications for the health section's article-writing contest on the topic of provider payment reform.

Description: A new health insurance pricing model takes external market prices into account, as well as regulatory rate restrictions and other traditional pricing factors. Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral & loss ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has a healthier than average mix of risks.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

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

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

Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.

Description: New research shows that we often make sub-optimal choices, when selecting a health insurance plan, that lead to unnecessary out-of-pocket expenditu

Description: This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness.

Description: A proposal to reform the health care provider payment system through: a national fee schedule, shifting more reimbursements to primary care providers, better integration of hospital & physician fees, evidence based care, pay for performance, and a better provider risk sharing mechanism.