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 author discusses the Genetic Information Nondiscrimination Act of 2008 GINA and its ultimate effect on the long-term care industry in general, and on current and future insureds, specifically.

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: Article describes enhanced primary care models and provides citations on whether or not health care savings have been achieved.

Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.

Description: The article reviews high-deductible health plans and poor reimbursement for mental health providers as being the root of 3 devastating problems facing the US.

Description: Presentation on estimating rates of early-onset Alzheimer's Disease. This document contains incident rates, critical illnese insurance information, adverse selection, and more.

Description: Chapter 2 reviews previous research in the area of health risk assessment. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.

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: In this video Mitchell Momanyi, FSA MAAA presents an informative breakdown of Medicare Advantage plans, delving into the intricacies of this alternative to traditional Medicare. Covering the inception of Medicare Advantage and its evolution, Momanyi explores the managed care companies offering Part C coverage, emphasizing the role of provider networks coordinated care. Concluding with key considerations for beneficiaries, Momanyi stresses the importance of weighing the pros and cons between Traditional Medicare and Medicare Advantage, while also emphasizing the evolving nature of the Medicare landscape and the regulatory nuances influencing enrollment decisions. Conributors: Mitchell Momanyi, FSA, MAAA, Deana Bell FSA, MAAA, Matt Emery, FSA, CERA, MAAA, Jon Forster, ASA, MAAA