Description: Chairperson's note to readers.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: During the past few years, performance, cost, and risk trends for Medigap products have undergone substantial changes. Some of these trends could ease cost pressures on Medigap insurers, while others might increase them. Part 1 of this Issue Brief article discusses current changing trends and considerations around about how they are impacting Medigap.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: A proposal to address provider payment issues by gradually moving to accountable care organizations. Capitations would be risk-adjusted, non-capitated costs would be covered by hospitalization fund and stoploss, incentives for quality & effective preventive care would be tied to the amount remaining in the fund, and government involvement would be through incentives rather than mandate.

Description: This article discusses projects of the Heath Section Council.

Description: This article takes a comparative review on Medicare and Private Health Insurance and examines the cost of administration. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: Article is about a new course developed in actuarial science taught at Columbia University. Course covers traditional health actuarial projects but is expanded to cover issues for a health insurance company executive (e.g., CEO, CFO, etc.). The course also includes studying of other international healthcare systems plus healthcare reform (PPACA). Students were involved in research projects, including healthcare reform and international health systems. Students also had to teach a course as part of their final exam.

Description: An excerpt from a presentation at the 2014 Living to 100 Symposium, this article describes an open-source model for use by actuaries attempting to estimate future health benefit costs, discusses its strengths and limitations, and projects that spending for those age over 65 will take more than $13 trillion by 2055, about 50 percent of total medical expenditures.

Description: Editor's comments on the publication