Description: Social determinants of health (SDoH) have been a topic of growing interest in recent years, yet consensus about what the phrase represents and how health-related social needs should be studied or addressed by employers, health plans, providers and other stakeholders in the business of health care have been lacking. For many, low-income populations come to mind when considering the topic, yet SDoH include a wide range of factors beyond income. Many types of data are available, yet each presents distinct challenges and opportunities for analysis. In this article, we describe some of the underlying context for considering SDoH, as well as some of the potential data sources to consult and challenges to grapple with on this important topic.

Description: Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements

Description: This article on IPV focuses on IPV during the COVID-19 pandemic

Description: Presenter discusses issues related to alternative care, as well as SOA activity in regard to alternative care. From the Record of the Society of Actuaries, Vol. 24, No. 1.

Description: Panelists discuss major reforms of health care financing and delivery systems around the world. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: Summary of Medicaid encounter data, including how it is collected by health plans, transferred to state databases, used by states, and ultimately sent to CMS. The status of the CMS T-MSIS project is discussed, as well as the future of Medicaid encounter data as a source of information for many stakeholders.

Description: Methods and assumptions used in the valuation of savings by external care vendors

Description: Presenter examines federal and state efforts at parity in the area of mental health insurance. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act