Description: Feature article discussing the impact of health care reform on the direct insurance market and the reinsurance market.

Description: This is a discussion of the medical loss ratio, the confusion and debate over the calculation method under the new MLR requirement, and the opportunities it presents to consulting actuaries.

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: Coverage of Medicaid home and community-based services under the 1915(i) state plan option: Attractive features and important considerations

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: Congress authorized the creation of the RAISE Family Caregiving Advisory Council in 2018. The Council, comprised of family caregivers and experts from a wide variety of stakeholder organizations in both the private and public sector, have been engaged in an in-depth research effort over the last two years to develop recommendations and an implementation plan to address our national caregiving crisis. This article describes their work and the newly released Report to Congress.

Description: From a session at a meeting of the Society of Actuaries held in San Diego, CA, June 22-23, 2000 The panelists discuss distribution systems that are viable in the future with emphasis on the middle markets.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: 2021 Life Meeting - Session 8A: Use of Electronic Health Records in the Assessment of Life and Health Risks 9.1.21 Recording

Description: In PLR 202109001, the IRS ruled that a proposed assumption reinsurance transaction between related foreign parties changing the counter party obligated to a domestic corporation (“Taxpayer”) under an existing agreement did not give rise to Taxpayer being treated as making a base erosion payment (“BEP”), as Taxpayer did not receive a deduction under §832(b)(4)(A) from the amount of gross premiums written on insurance contracts during the taxable year for premiums paid for reinsurance.