Description: Calculation of IBNR Reserves compares IBNP lag method to Incurred Claims PMPM method which produces lower Variance. Issue No. 46.

Description: This article summarizes what is new with the Academy health practice council. Issue No. 59

Description: Healthcare risk adjustment methodologies have become increasingly complex, largely due to the belief that complexity enhances accuracy. However, a disconnect exists between how healthcare risk is assessed and how payments are adjusted. This article explores the stark difference between measuring the accuracy of a risk assessment model at a member level, and that of a risk adjustment mechanism at the health plan level. I show that a highly simplified approach that does not use diagnosis codes can have similar accuracy on risk adjusted payments to models that do. These findings suggest that accuracy is not a barrier to developing simpler risk adjustment methodologies, which can improve payment accuracy and reduce the financial incentive for coding diagnoses.

Description: This article discusses the causes of the 1918 influenza pandemic, the reasons it occurred and the likelihood that it could happen again. In addition, the author discussed ways, in general, to model and manage risks that occur infrequently, yet have a significant impact.

Description: This article describes some of the traditional profit measurement standards for direct marketing and then presents a more comprehensive and up-to-date foundation for insurance direct marketers and actuaries to use when reviewing individual direct marketing campaigns or total marketing programs.

Description: This article gives an overview of the worksite marketing/volutary products market and addresses the pros and cons of this marketing approach.

Description: This abstract describes a paper that describes two predictive models for hospital readmission rates using patient level data with specific patient information.

Description: Key aspects of credibility formulas & modeling, experience data requirements Issue No. 37.

Description: NAIC Health Update. Issue No. 44.

Description: This corner serves to update the membership of some of the section’s milestones for this year, set the trajectory for 2009, and thank the many dedicated individuals and teams who made it happen. Issue No. 59