Description: Article presents new course readings that cover hot health topics that will expand actuarial expertise in the Health Systems practice area.

Description: Article is about community rating and risk adjustment including possible disadvantages for healthy experience-rated or self-insured groups.

Description: This is one of a series of SOA-sponsored papers on the subject of Evaluating the Results of Care Management Interventions. This paper addresses the theory of measurement design and provides a practical evaluation of the most common designs for the practitioner.

Description: Does disease management DM positively influence health care costs? According to three prestigious sources, the answer is no. From Financing Chronic Care Monograph, M-HB05-1.

Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: Essay discussing that the two factors that affect healthcare cost are costs and the fact that people lack coverage.

Description: This paper discussed providing consumers of medical care with transparent and comparable price and quality information to enable them to make economically optimal decisions.

Description: The essay discusses the appropriate role of insurance companies, efficient and economical ways to care for chronic illnesses and having a maximum price society will pay to support the ongoing life of any one individual.

Description: This essay highlights a view that many have for meeting these goals is one of a two-tiered system. The first tier in this system is a universal one controlled by the federal government, while the second tier is a private sector supplementing the first tier. The remainder of this paper will examine this two-tiered system and how various stakeholders in today’s system will be affected.

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.