Description: The article focuses on the use of predictive analytics in the development of experience studies, pros and cons of using predictive analytics versus traditional techniques, and the implications for setting assumptions and improving profitability.

Description: This article explores the changing risk profile between the transitional Affordable Care Act (ACA) period (2014-2016) and under the final ACA period (beyond 2017) for the individual market. Actuaries are in a unique position to help facilitate the change from the current ACA period to the final period when health plans will have to take on substantially more risk.

Description: The article explores how deeply the Affordable Care Act reduced the Medicare Advantage benchmark payment rates and quantifies how much of that reduction Medicare Advantage Organizations earned back through quality bonuses.

Description: If your organization’s objectives involve taking on other people’s risks, you need some pretty complicated goals for your risk taking: diversification, risk selection, control cycle, consideration and provisioning.