Description: In this report, we explore the impact of clustering using the Medical Expenditure Panel Study (MEPS) data for children (aged 5 to 17) to build a bridge between oral health and overall health using dental and medical expenditures. We include social determinants of health as cluster input variables using the Partitioning around Medoids (PAM) method to identify children and their families who could potentially benefit from population health management related to oral health.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.

Description: This report provides highlights of a weekly survey of practices regarding the mitigation of the spread of COVID-19 in the U.S. during the first half of January 2021 along with comparisons to prior half-month time periods. The survey asks about the degree to which the respondents perceive that people in their community are following 21 common mitigation practices. The responses are separated by state and compared to state level statistics regarding the level of COVID-19 infections from the Johns Hopkins COVID database for the same time period.

Description: Max Rudolph's winning essay.

Description: Article discusses causes of high charges in relations to reimbursement arrangements and possible actions of insurers & payers. Issue No. 45.

Description: A high level summary of the basics of Medicare Part D settlements - what they are, and the impact they have on plan sponsors' final financial results. Intended for an audience with limited familiarity with Medicare Part D.

Description: Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Direct-to-provider contracting is a strategy in which a self-insured entity negotiates a contract directly with a provider of healthcare services rather than through a third-party administrator (TPA), often with the goal of driving value-based care. This article discusses the considerations for employers and providers with direct-to-provider contracting.

Description: This article explores the disruptive applications of blockchain, an emerging technology, and its impact on the pharmacy benefit space, and pharmacy benefit managers (PBM).

Description: This article provides summaries of the sessions sponsored by the Nontraditional Marketing Section at the recent SOA meeting in Orlando Florida. Topics included measuring sales success, professionalism and the cost of medical malpractice.

Description: Feature article with helpful hints on video conferencing and more!