Description: December 2003 Issue No. 10 of Long-Term Care

Description: The last three decades have witnessed an important rise in number of people with diabetes in Asia, especially Type 2 Diabetes. Like no other common condition, numerous innovations are currently entering the healthcare system that will soon have a significant impact on management of the condition. This presentation explores the role played by sensors/wearables, artificial intelligence, new drugs and diabetes apps. We assess the realistic potential of such advancements and give an outlook on medium-term pricing and product development.

Description: The Casualty Actuarial Society, Canadian Institute of Actuaries, and the Society of Actuaries' Joint Risk Management Section and the Joint Risk Management Research Committee are pleased to make available a new report on the application of ERM. Authored by Bonnie-Jeanne MacDonald, Sim Segal, Michael Wolfson and Heidi Walsh, the report provides a novel demonstration on how ERM can be applied to serve the Canadian public by informing decision makers on the risks facing the current and future delivery of long-term care.

Description: The SOA’s Health Care Cost Trends Strategic Research Program highlights trends in health care costs and high cost claimants, impacts of population driven risk factors on health care costs and innovative approaches to keeping costs in check.

Description: This report describes two methods, an observation-based analysis and an actual to model analysis, to analyze long-term care insurance experience to determine if calendar year trends exist.

Description: The Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

Description: Through the sponsorship of the Robert Wood Johnson Foundation, The Society of Actuaries partnered with Wakely to use their health care data to study the effects of COVID-19 on overall health care claims for individuals with a COVID-19 diagnosis. The conclusion of the study is that individuals with COVID-19 claims had significant increases in health care costs leading up to their months of diagnosis, as well as in the months following their diagnosis. These effects were more pronounced for individuals who were hospitalized due to COVID-19 as well as for individuals with prior co-morbidities. Finally, the overall health care costs of these members plateaued at significantly higher levels than their pre-COVID baselines. In fact, all the main membership cohorts experienced claim levels that were at least 20% higher than their pre-COVID starting points.

Description: This research report provides an evaluation and synthesis of the methodologies and data samples used on characterizing health care fraud.

Description: Most actuarial explorations of increased longevity have, quite understandably, focused on its direct financial implications for things like health care costs, retirement systems, and social security or other public policy provisions. But future life extension has many other potential implications, both direct and indirect, for various socioeconomic factors, which in turn have the potential to affect the actuarial valuation of future risk contingencies. This paper examines a sampling of the socioeconomic issues emerging from the possibility of substantially increased longevity. Because of the complexity and interrelatedness of these issues, actuarial and risk modeling of this prospective environment could be a significant challenge.

Description: This SOA report describes the components of margin for calculating capitation rates in a Medicaid context along with practical issues that MCOs may face.