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.

Description: This paper describes seven methods used in care management in the order of their historical development: 1. Pre-Authorization 2. Concurrent Review 3. Case Management 4. Demand Management 5. Disease Management 6. Specialty Case Management 7. Population Health Management Paper 1 of a 8 paper series

Description: Panel discusses the effects of reduced payment levels to many Medicare managed care organizations. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Panel discusses trends in large health claims, recent experience, and future expectations, as well as the impact of managed care on large individual health claims under self-insured programs and under an HMO setting. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: The measure of a health-care provider's quality and efficiency can be used to reward or penalize the provider through reimbursement strategies and plan designs. Panelists discuss the measures that are becoming available. From the 2002 Record of Society of Actuaries, Volume 28, No. 2. Session 24PD of the San Francisco Spring Meeting.

Description: This session from the 1994 Valuation Actuary Symposium focuses on long-term projections of health insurance, the uses of the projections, the type of model to use and model considerations for the projections.

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: Read the October 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: This is a panel discussion session on the purpose, rationale and conclusions of the Committee for Accident and Health Valuation Principles. Discussion also covers the comments received and any modifications to their original draft report.

Description: Surplus and the ACA