Description: Provides an overview of developments in the healthcare market including provider billing practices. Provides an overview of the Government Finance Officer’s Association (GFOA) in New York on Dec. 6, 2018

Description: This study was sponsored by the Society of Actuaries Health Section. This paper explores the relative significance of aging as a determinant of financial cost of health care beyond age 50, with particular attention to the effect for ages 65 and older. The paper presents concepts of aging factors and aging curves, which define relative values between ages for utilization or cost of health care services. General conclusions are drawn from Medicare data that utilization and cost differ by age, but that aging factors vary across services and may be less significant at very old ages. The author then turns to the question of measuring the significance of an aging curve assumption and what accuracy is lost in the simpler alternative of a single value across an age range.

Description: This paper describes seven methods used in care management in the order of their historical development: 1. Pre-Authorization 2. Concurrent Review 3. Case Management 4. Demand Management 5. Disease Management 6. Specialty Case Management 7. Population Health Management Paper 1 of a 8 paper series

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

Description: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.

Description: This is one of a series of SOA-sponsored papers on the subject of Evaluating the Results of Care Management Interventions. This paper addresses the theory of measurement design and provides a practical evaluation of the most common designs for the practitioner.

Description: In this era of rising health care costs, numerous efforts have been made to link quality and cost through multiple approaches. This is a report of a study, conducted by MPRO under contract with the SOA, in which they evaluate whether quality pays or not in an inpatient setting by carefully selecting a few hospitals in Southeast Michigan and retrospectively calculating their return on investment [ROI] in quality improvement [QI] activities within their organization.

Description: The Society of Actuaries' Pension Section and Health Section Research teams commissioned Professor Thomas E. Getzen of Temple University to construct a resource model for the projection of long term healthcare cost trends. The motivation for creation of the model was driven by its potential usage as a resource for the estimation of reportable liabilities for retiree healthcare benefits as specified under FAS 106 and GASB 45 accounting statements. This model, programmed in Microsoft Excel [xlsx format], projects per-person expenditures and growth rates through 2099 using a set of equations and assumptions developed by Professor Getzen with assistance from the Society of Actuaries Project Oversight Group appointed to oversee the effort. The model includes baseline assumptions as well as flexibility for user–inputted alternative assumptions.

Description: As part of the SOA’s July 22, 2020, COVID-19 Virtual Symposium, Marketing and Distribution (MaD) Section Council members presented “Selling Insurance Six Feet Apart” with insight into emerging sales and marketing processes, challenges, and opportunities for the product spaces noted

Description: There are early indications of a six year cycle in ACA markets reminiscent of the traditional underwriting cycle.