Description: This is a regular column highlighting articles of interest to Health Actuaries appearing in the North American Actuarial Journal.

Description: This paper outlines a framework for assisting a STARS manager in implementing a quantitative approach to prioritize stars measures for targeted intervention

Description: The ACA’s Medical Loss Ratio Provisions

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: Introduction to the ACA @ 5 publication

Description: This dissertation by Tia Sawhney will help you understand this issue and start measuring it, or start promoting equitable public policy.

Description: Inspired by other financial savings products available to Canadians, this article describes a potential solution for financing future health expenses with the creation of a Registered Health Savings Account (RHSA). This solution has been thought on the basis of four premises : 1- Individual Accountability for Health Expenses; 2- Early Savings Leads to More Accumulation; 3-PreferredTax Treatment for Personal Health Savings; 4- Complementing current public and private health systems; Main elements of the RHSA are described (Contributions, Accumulation, Utilization of account, Management by financial institutions).RHSA'S expected balances and some other results under three scenarios (a person in good health, one in poor health, and one with unexpected death at age 45) are summarized in a table. Health expenses deducted yearly from RHSA's balance were estimated using total, per capita, provincial government health expenditures by age-band for Canada, in 2020, from the Canadian Institute of Heath Information’s (CIHI), which account for 71.8% of total expenditures, that is public + private. Thus 28.2% of total expenditures were used for private health expenditures, then forecasted to 2024 and projected using a 4% annual trend. Some objections to the solution explored were anticipated as well as some refutations to these objections.

Description: Individual Market and ACA Products Actuarial rating principals