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.

Description: This article contains a condensed summary and excerpts from a recent white paper regarding the Individual Mandate.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.

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: Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will Republican health care reform look like?

Description: An economics professor and a health care consumer advocate weigh in on the Patient Protection and Affordable Care Act, including implementation issues, directions for the future and what role actuaries shoudl take.

Description: Updates on the efforts of the Academy’s health practice council. its work groups and task forces, to educate health care policymakers on issues including health care reform, Medicare, loss ratios, premium review, reinsurance, benefit and eligibility changes, exchanges, and risk based capital.

Description: We propose using premiums and tax revenue to fund high-cost individuals in the Individual ACA market.

Description: Shannon Brownlee shares her perspectives on the current health care crisis, including: inconsistent treatment patterns across providers and geographic regions, providers lacking evidence-based guidelines, the need for better independent clinical research to establish those guidelines, and the limits to consumerism's potential to fix the crisis.

Description: Updates on HPC activities, including new work groups for providing input to key players as health care reform moves on from the legislative phase into the regulatory phase, as well as ongoing activities of existing workgroups in financial reporting, long term care, stop loss, disease management, Medicare SUpplement, sovency, cancer claims experience, and risk adjustment.