Description: Mortality in the U.S. states at ages 80 and older and over years 1959–2011 analyzed and compared with mortality levels in 13 high-longevity countries.

Description: This session will explore the national landscape of state Medicaid risk adjustment program design & application and the key differences that drive effective managed care organization program management. Risk adjustment is a mechanism to adjust capitation rates between Managed Care Organizations to account for population morbidity differences. Although many states utilize this mechanism, the application of risk adjustment can vary significantly across states. The primary differences include populations, risk score models and data collection. These state application nuances affect the strategies and tactics utilized by MCOs for effective risk adjustment program management including provider financial alignment, encounter data submission and the capture of accurate diagnosis codes. The session is intended for Medicaid Managed Care Actuaries working to develop or support comprehensive risk adjustment program management functions.

Description: Presented at April 1986 Spring Meeting. Defines programs related to providing long-term care for the aging population through Life Care Societies 'LCS', nursing care products, Continuing Care Retirement Communities, etc. and actuarial considerations related to LCS in establishing funding requirements and evaluating liabilities.

Description: In the United States, individuals needing long-term services and supports (LTSS) access care, utilize services, and pay for their services in various ways. The authors explore how the need for, utilization of and payment for long-term services and supports differ in the U.S. by population cohorts. Their primary focus is disparity by race and ethnicity, but they also consider variations by geography, family structure, age, sex, gender and other socioeconomic factors.

Description: At this presentation from Session 7PD of the SOA 1996 Colorado Springs Meeting, the panelists comment on the value they place on ensuring proper management of risk, contract preparation, underwriting and claim handling for long-term care policies. From the Record of the Society of Actuaries, Vol. 22, No. 2.

Description: This is the second installment of an article about using microeconomics and the concepts of embedded value to better manage and understand the profitability of direct marketing programs.

Description: In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) assumption. This is unfortunate, given the margin assumption is one of the most critical components of the rate development in ensuring financial solvency of the Medicaid managed care organizations (MCOs). In this session, we will discuss the primary components of the this assumption and will share working models that help actuaries quantify these components—including the cost of capital and risk (or contingency) margin. We expect a lively discussion as we “open the black box” and discuss these actuarial assumptions in the public for the first time.

Description: This is a panel discussion about the future of health care and health care insurance. From Transactions of Society of Actuaries 1968, Vol. 20 Pt. 2, No. 58

Description: Observations of a Home Health Care Experience Analysis incidence rates, selection rates, avg length of service. From Long-Term Care Newsletter, October 2000, Issue No. 3.

Description: Presented at May 2000 Spring Meeting. Many long-term-care insurers are outsourcing administrative functions to management organizations. The panelists discuss the reasons for this outsourcing, the functions that can be outsourced, financial incentives for vendors, criteria for selecting a vendor, monitoring performance and other aspects of the business relationship.