Description: This article is directed to the payors—especially self-funded employers and TPAs—that seek to improve the health of the populations they cover in addition to administering the plan. Greater use of primary care is one way to better manage the health delivery. The results should also impact costs in a measurable way. Issue No. 59

Description: Summary of the health section council’s research project to assess the accuracy of commonly used IBNR estimation methods over a wide range of scenarios.

Description: Medicaid and the ACA

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: Read the March 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

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

Description: Actuaries should understand the economic considerations involved in the formulary drug decision-making process, and the presence of actuarial input in the process could improve it, especially by tying it to overall decision making for the health plan. From Prescription Drugs Monograph, M-HB04-1.

Description: Round table discussion regarding the pros and cons of the Affordable Care Act.

Description: This article focuses on the minimum value calculator and the methodology used. It proposes potential future improvements to this model.

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