Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: Realizing the impact of medical errors on the U.S. health care system, the Health Section commissioned a research project to measure the annual frequency of medical errors and their total measurable direct and indirect cost to the economy.

Description: Comparison of healthcare costs for early retirees versus active workers in the same age band. When adjusted for age, there is not a significant difference in costs between each group.

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

Description: A closer look at family tier factor rating assumptions, and how well they reflect actual claim cost data.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

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: Analysis of the impact of disease progression and treatment on life expectancy provides perspective on the long term costs to the health care system of chronic medical conditions.