Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: This paper discussed providing consumers of medical care with transparent and comparable price and quality information to enable them to make economically optimal decisions.

Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018

Description: In this article, the author discusses the Georgia Uninsured Working Group and their recommendations on solutions for the uninsured in Georgia through new HRA/HSA laws. Issue No. 59

Description: This article relates the health insurance industry to baseball retain & grow business while making a profit, competition, additional product offerings, evaluating risks. Issue No. 59

Description: A summary recap of the recent SOA Health Conference held in Dallas, TX in June of 2025. With the intentional use of AI to assist with the summary, this article gives a good overview of the recent conference with personal commentary from one of the attendees.

Description: Editor letter detailing article and encouraging authorship.

Description: In order to encourage health insurance issuers to offer health insurance coverage on the Exchange and on the individual and small group markets, while ameliorating the potential impact on any particular health insurance issuer of providing coverage without pricing for pre-existing conditions or the gender of the insured, the Affordable Care Act includes three risk-sharing programs: the Transitional Reinsurance program, the Risk Corridor program and the Risk Adjustment program (collectively referred to as the “3Rs”). The financial and tax reporting of each health insurance issuer is affected by the implementation of these risk-sharing programs because each health insurance issuer is required to pay for the programs’ costs, and some issuers are or will be eligible for benefits under them.

Description: Essay stating accessibility, affordability and efficiency are the key to success in the future of healthcare.

Description: "This video by Danika Turner is an introduction to Medicare Advantage revenue, specifically focusing on how Part C revenue works for individual Medicare Advantage plans. It explains how health plans participating in the Medicare Advantage program are paid by the Centers for Medicare and Medicaid Services (CMS), including the impact of Star ratings, risk adjustment, and county-level CMS benchmark rates on revenue. The session aims to simplify the main variables of the revenue calculation and uses conceptual examples for individual MA plans, excluding certain populations like Employer Group Waiver Plans and members with End-Stage Renal Disease or in hospice. The video also covers the basics of Medicare-covered services, mandatory and optional supplemental benefits, and the calculation steps for determining CMS Part C revenue per member per month.