Description: This presentation uses a dataset provided by a private insurance company which contained demographic, cost, and diagnostic data which allows the determination of which factors drove costs up and how these factors will affect the total cost for future years.

Description: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.

Description: This article, an Honorable Mention Essay for the Society of Actuaries' Entrepreneurial Actuaries Section 2010 Papers Competition, is a discussion of the various issues relating to measurement of data in healthcare. The author presents “a light hearted & tongue-in-cheek take on how healthcare is typically measured, and an entrepreneurial vision for a better world.” Noting that typically data is summarized in deterministic models that produce point estimates for analysis and decision making, the author’s vision presented in the paper “is that of a central repository of actuarially modeled distributions that can either be used as benchmarks or adapted to an organization's experience.”

Description: The author reviews the impact of health care exchanges becoming operational in 2014, and he offers ideas for efficient risk identification and ways to measure the results.

Description: The Society of Actuaries' health leadership met earlier this year for an all-day meeting in Chicago. A significant portion of that meeting was spent discussing current challenges facing the U.S. health care system and how the SOA can best serve its members by addressing top priority issues. The Actuary Magazine, April/May 2005

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: Discussion of recent developments in the taxation of noncoordinated benefits such as fixed indemnity, hospital indemnity, and specified disease insurance policies. Developments include a recent Chief Counsel Advice Memorandum and proposed triagency rulemaking that would impact non coordinated benefits.

Description: An essay discussing universal access to high quality, low cost health care.

Description: Essay stating Americans need to invent, implement, and evaluate sustainable health care policies, divert cash-flow streams away from projects which feed the beast and focus on projects and policies which enhance value. It will require a combination of thoughtful, coordinated policies and a change in our cultural expectations of infinite resources and unlimited choice.

Description: Brief discussion of future anticipated health reform and information on papers discussing these reforms. Topics include Medicare, individual insurnace, tax credits & subsidies, pre-Medicare retirees and Medicaid