Description: Conditions and required solvency standards of federal waiver to PSOs to provide Medicare+Choice products. Effect on providers, beneficiaries and employers. Issue No. 36

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: This section describes the basic methodology and assumptions used in the estimates for the HI trust fund under the intermediate assumptions. In addition, projections of HI and SMI costs under two alternative sets of assumptions are presented. From Pension Section news, September 2004, Issue No. 56.

Description: This article discuss the historical regulation and changes to the Medicare Physician Fee Schedule - MPFS.

Description: This is an article explaining the options employers have under the Medicare Part D, or the Prescription Drug Improvement and Medicare Modernization Act - MMA - that took effect in January 2006. The article discusses 4 options under the MMA with the advantages and disadvantages of each.

Description: Graph of Medicare Prepaid Contracts

Description: Two Medicare risk funding provisions that were radically changed by the BBA of 1997 funding variations by geographic area and risk adjustment. Issue No. 36

Description: Congress has been debating a revision to Medicare Advantage payments including limiting payments to the Medicare Fee-For-Service FFS cost. A county-specific impact study to the benchmark payment rates for each county nationally based on the FFS limitation criteria was performed. This article includes results for Florida, California, Pennsylvania and New York.

Description: Provides background about Prescription Drug Plans, PDPs, and the standard benefit package offered under Medicare Part D. It also provides a basic overview of the bid-development process for a PDP and summarizes some general strategies and observations used in developing the 2006 bids that will likely be used for 2007.

Description: Issue No. 36. Issues relating to Provider Sponsored Organizations PSOs contracting with HCFA to sponsor Medicare + Choice. Article discusses revenue and the addition of non-Medicare covered benefits.