Description: Read the February 2018 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: This presentation is a panel discussion, session 54PD, from the 2004 Spring Meeting of the Society of Actuaries, held June 14-15 in San Antonio, TX. This session covers the impact of segmentation and underwriting on expected mortality and morbidity. Panelists discuss the importance of data mining and customer selection on ultimate experience, setting up direct marketing applications with the right type of questions to maximize responses but limit risk, the use of prescription drugs and other databases, and industry practices for obtaining customer information. Discussion from participants is included. From the Record of Society of Actuaries, Volume 30, No. 2.

Description: Joe Wurzburger, Staff Fellow at the SOA, shares his views and insights about the health care industry in general and the Health Section's role in particular.

Description: How benchmarking actual performance to a published source is a useful tool in assessing the value added by a particular program or MCO, Issue No. 38.

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

Description: This report describes the results of a survey on reflecting risk in pricing. The survey expands on one conducted in 2003 and was expanded to include life, health, P&C, and non-North American insurance companies.

Description: Healthcare risk adjustment methodologies have become increasingly complex, largely due to the belief that complexity enhances accuracy. However, a disconnect exists between how healthcare risk is assessed and how payments are adjusted. This article explores the stark difference between measuring the accuracy of a risk assessment model at a member level, and that of a risk adjustment mechanism at the health plan level. I show that a highly simplified approach that does not use diagnosis codes can have similar accuracy on risk adjusted payments to models that do. These findings suggest that accuracy is not a barrier to developing simpler risk adjustment methodologies, which can improve payment accuracy and reduce the financial incentive for coding diagnoses.

Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.