Description: Article reviews the data a year into the unwinding of continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates have been adjusted, and compares those results to what has been modeled with the SOA Mediciad Unwinding model.

Description: There is a big wave of changes coming to the pharmacy market. The extent is not yet fully known, but there are trends we can follow that help us predict. Biosimilar uptake is key to driving savings, but it can take a while to ramp up. Biosimilars bring competition, and this coming wave will bring unprecedented Biosimilar competition.

Description: Meditation on life, choices and events during the COVID-19 pandemic

Description: This article notes the available pulications from Hank George, an underwriting expert, that will help keep you up to date on the subject.

Description: Outlines a generic business model for a life insurance company and concludes with thoughts on future trends and prospects.

Description: Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event. Savings from biosimilars have accelerated significantly in the past few years. There has been a number of relatively recent biosimilar launches that can help to shape our expectations of the financial impact that could result from this year’s big event.

Description: Two years ago, before COVID-19 changed everything about how we provide and receive health care, telehealth was largely provided by third-party vendors to treat a narrow range of acute one-and-done conditions. The value proposition was simple: a fast and easy member experience would drive satisfaction and engagement; high member satisfaction and engagement would drive health plan savings and member retention. Clearly, from the perspective of utilization, telehealth—as a viable alternative to in-person care during a pandemic—worked. And with COVID-19’s nudge—or was that a push?—toward cultural acceptance, the health care system is in a better position to capitalize on telehealth’s original promise of expanded access, lower cost and better outcomes than it was two years ago. But in the wake of the pandemic, it is just as clear to us that if telehealth is to live up to its full potential, some changes are needed. The rest of this article presents five ideas for improving the delivery of telehealth going forward.

Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits.

Description: Derek Ray shares his excitement on serving as Chair of the Health Section Council in 2024, including recent section achievements, upcoming activities and a call to action for volunteers to contribute their expertise to the SOA.

Description: Comparison of domestic and international PFML programs