Description: "This video by Danika Turner is an introduction to Medicare Advantage revenue, specifically focusing on how Part C revenue works for individual Medicare Advantage plans. It explains how health plans participating in the Medicare Advantage program are paid by the Centers for Medicare and Medicaid Services (CMS), including the impact of Star ratings, risk adjustment, and county-level CMS benchmark rates on revenue. The session aims to simplify the main variables of the revenue calculation and uses conceptual examples for individual MA plans, excluding certain populations like Employer Group Waiver Plans and members with End-Stage Renal Disease or in hospice. The video also covers the basics of Medicare-covered services, mandatory and optional supplemental benefits, and the calculation steps for determining CMS Part C revenue per member per month.

Description: This is a brief report that summarizes recent changes in the prevalent medical loss ratio methodologies and also looks at some of the more recent experience of health insurers that filed medical loss ratio reports.

Description: Essay suggesting to fix the tax code, reform healthcare regulations, open the industry to competition and reform malpractice litigation.

Description: Exploration of sources of volatility in retiree health valuations, noting how volatility arises and might be mitigated, with discussion of valuation parameters more problematic for retiree health benefits than for pensions. Three significant influences on retiree health valuation volatility are covered-- changes in benefit level, fluctuations in cost level, and alterations in eligibility for, or duration of, benefit – and attention focused on the last two. Specific conclusions result in recommendations, which are supported by practical examples contrasting volatile measurement results with those likely from the recommended practices. Theoretical discussion includes health claim variation, health trend usage, financial economics, option pricing, discount rates, and deterministic vs. stochastic modeling.

Description: This paper derives exact expressions for the ultimate ruin probability and establishes the effect of correlation on ruin probability using the Wiener-Hopf factorization.

Description: Epilogue to ACA@5 publication

Description: This paper discusses the need for actuarial judgment to be used in conjunction with statistical analysis in the calculation of incurred but not reported IBNR claim reserves.

Description: This article describes a method that can be useful when re-fitting a risk score model to a population of only moderate size. Learn how to use concepts like ridge regression to train a model with partial credibility.

Description: Health Care in Ireland public care, private insurance, risk adjustment Issue No. 39.