Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: Recap of content contained in the January 2014 issue of the Health Watch newsletter.

Description: Read the October 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: In this article, the author shares some opinions and observations derived from his experiences as a major reinsurer of stop loss in the early 80’s and as a rapidly growing stop loss MGU managing general underwriter in the 90’s. From Health Section News, September 2008, Issue No. 59

Description: Key findings from a market research study which the SOA undertook as part of their strategic initiative: Untapped Opportunities for Actuaries in Health.

Description: An economic analysis of bariatric surgery and health care costs supports the case for health plans to cover these procedures.

Description: Overview of opportunities for actuaries in business analytics, as well as the applied statistics and programming skills necessary to succeed.

Description: Health care predictive analytics varies between payers and providers as well as being a powerful tool in business decision modeling.

Description: Read the June 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.