Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: This session discussion is about high risk health pools: comparison of plans, what is working, experience and public policy considerations. From Record of Society of Actuaries Vol. 16, No. 1.

Description: As private payers ponders the early adoption of genomic testing to guide treatment pathways, can personalized approaches to care prove financially sound?

Description: Discusses management principles for the successful application of the underwriting processes of selecting and classifying risks and the actuarial pricing process of establishing adequate and equitable premiums for the risks to be underwritten within group medical business. Has some nice representative data for what a book of business might look like by case size.

Description: A summary of Medicare reform and its effect on prescription drug coverage.

Description: Individual Market and ACA Products Actuarial rating principals

Description: This article focuses on the actuarial value calculator and the methodology used. It proposes potential future improvements to this model.

Description: In the course of consulting engagements, actuaries almost always find they need one or more of the following resources: -Healthcare data, which may be at the individual patient level or on a particular population. -Health services research studies which describe, summarize, try to alter, or predict patients’ use of health resources. -Health policy information, which describe public or private actions which affect the access, cost and quality of medical care. This document describes the ever-changing resources and specifies where they may be obtained.