Description: An introduction to the National Academy of Social Insurance and how actuaries can contribute.

Description: Data file for Commercial Health Care Cost and Utilization Trends From 2009–2015 research report.

Description: An analysis of prescription drug use in the Kansas individual market

Description: This article highlights several state's Medicaid innovatioins, including cutting edge payment changes based on episodes of care, patient outcomes, and quality metrics.

Description: MHPAEA prohibits health plans from imposing financial requirements or treatment limitations on behavioral health benefits that are more restrictive than those applied to medical and surgical benefits. MHPAEA's regulations define treatment limitations to include nonquantitative treatment limitations (NQTLs), which are benefit design features that are not numerical, but otherwise limit the scope or duration of benefits.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

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: Recap of the health sessions at the 2014 SOA Annual Meeting.

Description: Opioids overdoses have contributed to increases in mortality among white American. This article gives some detail on the speed and the reach of the epidemic.

Description: In the Public Interest 2014 Issue 10 The Emerging Pricing: Shock in the Treatment for Hepatitis C