Description: The use of Risk Adjustment in Medicare Advantage (MA) has come under scrutiny due in part to a higher rate of increase of costs of its participating Health plans relative to traditional Medicare despite statutory requirements that reimbursement for these two programs must be actuarially equivalent.

Description: This report is presented in the form of a Tableau dashboard and is the sixth public release from this report series and contains the results of an excess mortality analysis for the fourth quarter of 2021. Data from 30 companies representing approximately 69% of the industry’s face amount inforce were included in the analyses in this report. A total of 3.2 million death claims from individual life policies from 2015 through December 31, 2021 make up the basis of the analyses. The report also compares the experience under COVID-19 of the insured population versus the general population.

Description: Pharmacy prices are top of mind for many consumers, policymakers, and payers. While there have been many efforts to reduce pharmacy costs over the years, many believe these efforts only helped us cope with the symptoms of the problem without providing a comprehensive cure for the underlying causes of this problem. The Society of Actuaries Health Section sponsored this Pharmacy Partnership Forum to gather multi-disciplinary experts in the pharmacy ecosystem. This report shares the insights and learnings that emerged from this group of health economics outcomes researchers, clinical pharmacists, medical doctors, health actuaries, benefits consultants and brokers, and their collective thoughts on advancing this exploration for society’s benefit.

Description: This collection of articles, essays and research reports look at the impacts of excessive heat on mortality, morbidity, property damage, and other costs, and the applications to actuarial practice and quantification of risks resulting from excessive heat.

Description: Different mortality projection methodologies are utilized by actuaries across applications and practice areas. As a result, the MIM Advisory Group developed a single framework to serve as a consistent base for practitioners in projecting mortality improvement.

Description: This report is a comprehensive survey of existing literature on mortality and race and ethnicity in the United States, examining disparities in mortality rates among different racial and ethnic groups. It explores factors influencing mortality differentials, including socioeconomic status, health care access, and other relevant aspects.

Description: This report is a comparison document discussing the regulatory frameworks for non-discriminatory AI usage in the insurance industry across different jurisdictions, including the United States, European Union, China, and Canada. It highlights current developments and regulatory bodies relevant to AI regulation in each region.

Description: This document discusses the process of obtaining regulatory approval for actuarial innovations in the United States. It includes information on the research project conducted by the Society of Actuaries and Milliman, insights from interviews with actuaries and regulators, as well as advice for presenting and defending innovative ideas.

Description: This report gives an update on the Getzen Model of Long-Run Medical Cost Trends for 2025-2035+, providing insights on key considerations, input parameters, and projections. It includes observations on long-term medical cost trends, budgetary resistance, and regulatory impacts on healthcare expenditures.

Description: The Society of Actuaries Catastrophe & Climate Strategic Research Program issued a call for essays to examine the extent climate change factors are or will contribute to excessive heat-related morbidity or mortality over the short or long term, including probable scenarios and projections of future morbidity and mortality costs, risks and uncertainties.