Description: This article discusses a study of the impact of the drug infliximab on Crohn's disease patients. This study had been approved in response to an SOA request for proposals for research on the health cost and utilization effects of a specific prescription drug.

Description: This is the abstract for the paper, Measuring DM Program Outcomes: The Use of Incident and Prevalent Populations by Ying Liu, MS and Michael Cousins, PhD.

Description: This paper addresses specific details of measurement principles and practice that the actuary should consider when planning to conduct or review a study of care management interventions. Three major topics are covered: Measurement Principles, Study Design Issues, and Risk Factors. Paper 2 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'

Description: Summary of cost-reduction and quality improvement within the disease management sector. Paper 4 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

Description: This paper describes an actuarial methodology for evaluating disease management outcomes. We address several important issues in this paper: • Control of exposure, • Identification of measured populations, and • Ensuring equivalence between baseline and intervention populations. - Paper 6 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

Description: Duncan's personal reflections on the state of care management evaluation.

Description: This article from major US payers describes palliative care as a scaleable means of improving quality and reducing costs during serious and complex illness.

Description: While there are many approaches currently being taken to transform health care, to be successful, we know that leading and planning for quality improvement is a science. Data is the common denominator as healthcare organizations establish best-practices, and ultimately overcome unintended variation through strong analytic systems. Health care leaders require specialized data analysis education and training to hone their skills in understanding and managing clinical variation. The problem with unexplained variation in healthcare is that it negatively impacts clinical outcomes, increases the cost of care, and diminishes value for patients. In this session, Dr. Ted James (BIDMC and Harvard Medical School Faculty) will explain how actuaries can offer practical solutions that provide insights into variations in clinical practice that cannot be explained by differences in medical conditions or patient preferences.

Description: This paper presents recent trends in obesity prevalence in significant population segments, including overall effects by age, gender and certain racial and ethnic groups, and discusses the ways in which obesity can influence mortality in each of these segments. It provides a synthesis of reported mortality experience relating to these behaviors by risk factors and diseases that will affect any mortality projection.

Description: This paper presents recent trends in obesity prevalence in significant population segments, including overall effects by age, gender and certain racial and ethnic groups, and discusses the ways in which obesity can influence mortality in each of these segments. It provides a synthesis of reported mortality experience relating to these behaviors by risk factors and diseases that will affect any mortality projection.