Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: The article reviews high-deductible health plans and poor reimbursement for mental health providers as being the root of 3 devastating problems facing the US.

Description: Preview of the Living to 100 Symposium.

Description: This paper describes seven methods used in care management in the order of their historical development: 1. Pre-Authorization 2. Concurrent Review 3. Case Management 4. Demand Management 5. Disease Management 6. Specialty Case Management 7. Population Health Management Paper 1 of a 8 paper series

Description: This is an abstract for the paper, Analysis of Costs for a Chronic Disease with Acute High Cost Episodes by Marjorie Rosenberg and Philip Farrell.

Description: Separating incident and prevalent populations is useful, but the use of a cohort to make an RTM adjustment is unwarranted in the population-based pre- versus post-period design. From Financing Chronic Care Monograph, M-HB05-1.

Description: Most health care delivered in the United States is based on the acute care model: it is episodic has a beginning, middle and end usually the patient recovers and interventions are designed to target a specific pathophysiologic abnormality. Chronic disease care, in contrast, often has no clear beginning and no end the focus is on managing over the long term with prevention of progression and complications. Further, many chronic diseases “travel together” comorbidities: for example, diabetes, hypertension, coronary artery disease CAD, heart failure, cerebrovascular disease, peripheral arterial disease and renal dysfunction are often found together.

Description: One of the first projects undertaken by Claim Analytics was to create a model to predict return to work for group insurance claimants with long term disabilities. This report, sponsored in part by the Society of Actuaries Health Section , is a case study on creating such a model.

Description: A review of literature regarding care management program outcomes - either financial or utilization-related which are indicative of financial improvement or from which financial conclusions may be drawn. Includes a discussion on utilization & concurrent review, case & demand & population & disease management . Paper 3 of an 8 paper series on 'An Introduction to Care Management Interventions and Their Implications for Actuaries'.

Description: This paper presents a different approach to measuring Health Expectancy, especially as it relates to the elderly population. This new actuarial approach is described and numerous examples are given.