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: Analysis of data from three Medicaid managed care plans examines enrollment and cost trends for newly eligible enrollees under the ACA's Medicaid expansion.

Description: A review of the 2009 Health Spring Meeting, which included speakers & sessions on the future of the SOA, U.S. health care reform, claims data issues & improvements, predictive modeling, underwriting principles, employer stoploss, cost trends, LTD & disability, and mental health parity regulations.

Description: This article is focused on sustainability concerns in the ACA individual markets and what we can learn from core actuarial principles as discussed in ASOPs.

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: A rethinking of current provider reimbursement, focusing on incentives instead of simply cutting fees. The recommended 2-pronged approach would feature integrated provider organizations as well as evidence-based decision making organized around episodes of care.

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: The editors of Health Watch have made health care reform the focus of the Sepctember 2009 issue, and provide an introduction to the issue's contents.

Description: A report on the proceedings of the June 2010 SOA health meeting. Leading topics included health care reform, opportunities to expand actuaries' roles, the global financial crisis, and collaboration with other organizations.

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