Description: Cost Effectiveness of Tumor Genomic Analysis and Immunotherapy

Description: A divisive confrontation over health care pricing is almost inevitable over the next few years. What will ultimately happen is a political decision, not an actuarial one—but it will have major consequences for the trend in health care costs and the divergence between public and private insurance premiums.

Description: Through the sponsorship of the Robert Wood Johnson Foundation, The Society of Actuaries partnered with Wakely to use their health care data to study the effects of COVID-19 on overall health care claims for individuals with a COVID-19 diagnosis. The conclusion of the study is that individuals with COVID-19 claims had significant increases in health care costs leading up to their months of diagnosis, as well as in the months following their diagnosis. These effects were more pronounced for individuals who were hospitalized due to COVID-19 as well as for individuals with prior co-morbidities. Finally, the overall health care costs of these members plateaued at significantly higher levels than their pre-COVID baselines. In fact, all the main membership cohorts experienced claim levels that were at least 20% higher than their pre-COVID starting points.

Description: Learn more about the reasons for provider consolidations and shortages as well as their impact on health care morbidity.

Description: The Society of Actuaries Research Institute’s Aging and Retirement Strategic Research Program is pleased to release three essays addressing the actuarial impact of mental health issues in retirement.

Description: The document is a literature review on maternal mortality in the United States, focusing on trends, disparities, measurement issues, data quality, and monitoring systems. It also discusses how different indicators and definitions impact the understanding of maternal mortality in the country.

Description: The is a comprehensive report on the development of an Underwriting Margin Model for Medicaid Managed Care programs, published by the Society of Actuaries. It includes disclosures, methodology, results, sensitivity analyses, and technical instructions for actuaries setting rates for Medicaid managed care programs.

Description: This report provides highlights of a weekly survey of practices regarding the mitigation of the spread of COVID-19 in the U.S. during the last half of April 2021 along with comparisons to prior half-month time periods.

Description: In this report, we explore the impact of clustering using the Medical Expenditure Panel Study (MEPS) data for children (aged 5 to 17) to build a bridge between oral health and overall health using dental and medical expenditures. We include social determinants of health as cluster input variables using the Partitioning around Medoids (PAM) method to identify children and their families who could potentially benefit from population health management related to oral health.

Description: Chronic Kidney Disease (CKD) affects many lives and has a large impact on health systems around the world. To better understand and predict costs for insurance plan members with CKD in the United States, we built a new model of their individual costs. Our model is the first to explicitly model both the CKD stage transition process and the distribution of costs given those stages.