Description: Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the impact big data and predictive modeling is having on the health care industry

Description: New NCQA Quality Assessment Program for PPOs discussing rationale and performance meansurements, Issue No. 38.

Description: Recap of Q&A sessions held to discuss the findings and methodology of a SOA study on the cost of the newly insured under the ACA.

Description: Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements

Description: Fifty-three percent of Americans responding to a survey conducted by the Society of Actuaries (SOA) Research Institute reported that extreme weather events – including hurricanes, tornadoes, heatwaves, wildfires and flooding – have adversely affected their health.

Description: The presenters will compare and contrast the Canadian public (and, to a lesser extent, private) health care system in juxtaposition to U.S. health care. Specialized knowledge of either system is not required. The presentation will focus on cost containment strategies balanced against effective health care services. Differentiation of strategies, such as wellness and prevention in contrast to diagnosis and treatment, will be discussed.

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: Summary of Medicaid encounter data, including how it is collected by health plans, transferred to state databases, used by states, and ultimately sent to CMS. The status of the CMS T-MSIS project is discussed, as well as the future of Medicaid encounter data as a source of information for many stakeholders.

Description: An overview of the issues behind reimbursing providers on a bundled or packaged basis. The article presents the potential advantages offered by the proponents as well as the criticisms and obstacles to implementing this type of payment system.