Description: Paper summarizes articles on quality care issues including - measurement & reporting, financing, patient safety, standards & education, and leadership.

Description: In this session, panelists present their views on the future of managed care in light of the current environment. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 118

Description: This session discussion legal liability for unfavorable medical outcomes, effect of utilization review on the quality of care and patient/provider acceptance, protocol development and implementation for managed care, and insurance coverage necessary to protect your organization. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: Overview of public health (responsibilities, funding, challenges) and discussion of the role actuaries can play in achieving population health goals.

Description: Discussion of how to mature value-based contracts between health insurers and provider organizations to improve population health and financial sustainability. Centers around contract parameter consistency, revenue predictability and risk assessment. Intended audience are health plan and ACO actuaries and leaders. Authors are writing from the provider perspective in value-based contracts.

Description: Essay discussing cost, quality and access of healthcare and then describes the need for rationing.

Description: This article reviews Canada's Medicare Plan, the Chaoulli Supreme Court decision and looks at factors affecting waiting times. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are increasingly exploring advanced population-based payment (PBP) models that increase flexibility, predictability, and accountability for participating provider organizations. PBP models show promise in advancing Medicaid priorities, but are still in the early stages of development, and model design and implementation challenges remain. This article from the Center for Health Care Strategies explores the fundamentals of VBP and how PBP - a particular type of payment model - can help Medicaid agencies achieve goals related to care transformation and quality improvement, revenue stability, and controlling cost of care.

Description: By rationing heath care resources, managed-care organizations have raised ethical and legal issues not commonly found under previous health-care-financing structures. Panelists, including a member of the Board and the Executive Committee of the American Medical Association [AMA], and the audience debate this issue. From the 1997 Record of Society of Actuaries, Vol. 23, No. 3.

Description: Introduction to additional actuarial research into development of and regulatory impact, economic impact and consumer impact of prescription drugs in the United States. Intended to further educate actuaries and others who work in this area and motivate more actuarial involvement to increase transparency, increase competition, better align stakeholder incentives and better mitigate total cost of care increases