Description: An excerpt from a presentation at the 2014 Living to 100 Symposium, this article describes an open-source model for use by actuaries attempting to estimate future health benefit costs, discusses its strengths and limitations, and projects that spending for those age over 65 will take more than $13 trillion by 2055, about 50 percent of total medical expenditures.

Description: An approach to quantify medical intervention savings when medical claims data is not available by leveraging overlapping measurement techniques.

Description: This article discusses the use of parametric distributions to model health care cost.

Description: Incorporating Pended Claims in Medical IBNR Estimates. Issue No. 45.

Description: Traditional risk scoring models include only fixed (non-random) demographic and condition-based variables. By including the provider effect as part of the risk scoring model as a random effect, we can get better estimates of provider performance (incorporating practice patterns conditional on patient morbidity profile). This approach can be generalized to study other factors that are now masked in error variance (i.e. area, Social Determinants) but if modeled could give us better estimates of risk

Description: A guide to the protocols and rules necessary to ensure an accurate savings comparison when using an historical claims repricing in the PBM RFP process.