Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.

Description: Discussion of state medicaid expansion due to provisions of the Affordable Care Act.

Description: There is a wide range of literature on aging and health care. We sample this literature and find it fits into the subcategories of theoretical aging, medical significance of aging, treatment of the elderly, and resource allocation to the elderly. Themes are that financial arrangements can cause inefficient and ineffective care and that care guidelines need to developed specifically for the elderly rather than extrapolating guidelines for younger patients.

Description: Analysis of possible mathematical relationships between hospital quality and hospital billed or allowed charges or other measures, using quality data as defined by the U.S. Department of Health and Human Services along with the Hospital Quality Alliance for their Hospital Quality Initiative.

Description: This article is about the most significant issues and trends that may impact long-term care LTC risks, care delivery and protection in the future.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: An excerpt from the 2002 Annual report of the Boards of Trustees for the Federal Hospital Insurance and Federal supplementary Medical Insurance Trust Funds which describes the basic assumptions and methods used in the estimates under the intermediate assumptions. Also, presented are projections of program costs under two alternate sets if assumptions.

Description: This article discuss the historical regulation and changes to the Medicare Physician Fee Schedule - MPFS.

Description: This report provides estimated savings for several of the options that are available to plan sponsors after implementation of the Medicare prescription drug program.

Description: This article reviews the Medicare Prescription Drug, Improvement and Modernization Act and the impact the legislation has had on Medicare Supplement plans, policies and the changes to the model regulation. From Health Section Newsletter, March 2005, Issue No. 49.