Description: The Patient Protection and Affordable Care Act (ACA) was signed into law March 23, 2010. The transformative health care legislation was multi-faceted, but its primary purpose was to reduce the number of uninsured Americans. In alignment with the SOA’s Strategic Plan objective to “inform the public’s understanding of key societal issues”, this report examines the various publications reporting on the uninsured rate which stakeholders frequently access to measure policy efficacy and inform future policy considerations.

Description: This is an Excel workbook that can be used as a tool for health insurance companies to model their potential risk exposure from an influenza pandemic. It is based on a model developed for a Society of Actuaries study examining the potential implications of a pandemic on the U.S. health insurance industry. The spreadsheet is saved with many of the same assumptions used in this research and reproduces the results of the exhibits contained in the June 2010 report, 'Potential Impact of Pandemic Influenza on the U.S. Health Insurance Industry.'

Description: Recap on the annual meeting, and in particular the sessions sponsored by the health section.

Description: Read the June 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: In April 2018, the Centers for Medicare & Medicaid Services (CMS) published a revised definition of primarily health related (PHR) benefits as applicable to Medicare Advantage (MA) organizations.

Description: The letter from the editor thanks all of the authors for their contributions and gives a very quick synopsis of what will be appearing in the June issue.

Description: Read the June 2020 issue of Health Watch published by the Health Section. Newsletters provide practical information for the working actuary, articles on trends that impact sections and news about section activities.

Description: ACA risk adjustment has now been in play for years. The original intent of risk adjustment was to help stabilize the market through measuring risk levels of each issuer. However, the risk adjustment program may have introduced additional uncertainty due to annual market shifts and model changes, making risk adjustment estimation is a difficult task. This article analyzes the results over time, including impacts from market changes and model changes.

Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.

Description: This article summarizes what is new with the Academy health practice council. Issue No. 59