Description: Panelists continue their discussion of a research project into actuarial issues and financial measurements related to disease management programs. Outcomes measurement is specifically discussed. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 41

Description: Disease management [DM] is a health care intervention targeted to individuals with chronic diseases chronics. To justify the investment by payers in DM, it is important to demonstrate beneficial clinical and financial outcomes. This paper analyzes the health cost trends between the chronic and non-chronic populations. Paper 7 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

Description: This paper applies the principles and methodologies discussed in earlier papers in this series to measure cost savings from a two-year disease management DM program for the 200,000 Medicare members of a regional managed care plan. We then study how savings estimates change when we allow for four variations in key assumptions: methods for identifying or excluding plan members, requirements for eligibility in the health plan, methods for calculating health care trend and study design. Finally, we also examine the sensitivity of these results to product type by comparing the Medicare results to those of the Commercial HMO/POS product. Paper 8 of an 8 paper series titled: “Evaluating the Results of Care Management Interventions: Comparative Analysis of Different Outcomes Measures” sponsored by the Society of Actuaries’ Health Section and the Committee on Knowledge Extension Research.

Description: Separating incident and prevalent populations is useful, but the use of a cohort to make an RTM adjustment is unwarranted in the population-based pre- versus post-period design. From Financing Chronic Care Monograph, M-HB05-1.

Description: Discussion of “Health Expectancy” paper and reply from author, Faye Albert. Discussion of Human Behavior: An Impediment to Future Mortality and Discussion of Health, Wealth and Wisdom - Living Long, Living Well: An Actuary Muses on Longevity

Description: This paper describes an actuarial methodology for evaluating disease management outcomes. We address several important issues in this paper: • Control of exposure, • Identification of measured populations, and • Ensuring equivalence between baseline and intervention populations. - Paper 6 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

Description: This paper presents recent trends in obesity prevalence in significant population segments, including overall effects by age, gender and certain racial and ethnic groups, and discusses the ways in which obesity can influence mortality in each of these segments. It provides a synthesis of reported mortality experience relating to these behaviors by risk factors and diseases that will affect any mortality projection.

Description: This paper presents recent trends in obesity prevalence in significant population segments, including overall effects by age, gender and certain racial and ethnic groups, and discusses the ways in which obesity can influence mortality in each of these segments. It provides a synthesis of reported mortality experience relating to these behaviors by risk factors and diseases that will affect any mortality projection.

Description: This is an abstract for the paper, Analysis of Costs for a Chronic Disease with Acute High Cost Episodes by Marjorie Rosenberg and Philip Farrell.

Description: This paper presents a different approach to measuring Health Expectancy, especially as it relates to the elderly population. This new actuarial approach is described and numerous examples are given.