Description: Electronic Health Records, or EHRs, are a major worldwide initiative to eliminate paper recordings – including Attending Physician Statements (APSs) – of an individual’s medical history and current treatment.

Description: The Health Care Cost Institute (HCCI) recently released their annual health care cost and utilization report on February 13, 2020. This report illustrates employer group commercial health care costs and trends from 2014 – 2018.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.

Description: A comprehensive primer on long-term care wellness programs, their design, implementation, challenges, metrics for success, and emerging industry practices.

Description: The cost of prescription drugs is top of mind for consumers, payers and policymakers. Despite legislative efforts, such as the Inflation Reduction Act, the problem remains. More than 30% of all Americans say they have not taken prescription drugs as prescribed in the last 12 months because of the expense. The purpose of this paper is to discuss an alternative to policy solutions: reimagining pharmacy financing in the commercial space using a value-based reimbursement methodology that increases transparency, encourages competition, aligns stakeholder incentives and mitigates total cost of care (TCOC) increases. This paper will demonstrate that it is possible to implement such a methodology under the current infrastructure, but one can identify limitations.

Description: “E-Cigarettes: A Hazard or a Help?” by Sam Gutterman was published online in the North American Actuarial Journal on December 18, 2019, and in print in Volume 24, 2020–Issue 4. This essay is the author’s update to the original paper; it has not been peer-reviewed. The essay is solely an expression of the views, opinions, and ideas of the essay author for applying the original research to actuarial work.

Description: The SOA Research Institute has been publishing its annual Getzen Model of Long-Run Medical Cost Trends for the past decade. The Health Care Cost Trends Strategic Research Committee is looking for a researcher to build on the legacy of the Getzen model and provide annual updates to the SOA’s long-term health care trend projections.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: The Health Care Cost Trends Strategic Research Committee is looking for a research proposal that will examine the increased uptake of diabetes drugs on overall medical trends as well as the costs of individuals who are prescribed these drugs.

Description: This is a Request for Proposals (RFP) issued by the SOA Research Institute (SOARI) seeking research studies related to anxiety, depression, and their impact on mortality in the United States.