Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: Susan Dentzer, editor-in-chief of Health Affairs, discusses health care and health policy.

Description: This article is an overview of preliminary research on HSAs and Account-Based Health Plans. The summary reviews enrollment, health status, premiums and account information. From Health Watch Newsletter, September 2006, Issue No. 53.

Description: This article provides an introduction to comparative health policy for developed, developing and third-world countries. From Health Watch News, September 2006, Issue No. 53.

Description: News from the American Academy of Actuaries

Description: The article is a case study of various actuarial concepts invovled in the design and implementtion of the AQC - a global budget provider payment arrangement implemented by Blue Cross Blue Shield of MA.

Description: The entire issue of Health Watch.

Description: When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates into a final recommendation. This paper describes two techniques that can be used to combine these estimates that may result in better accuracy and lower variance.

Description: Article describes enhanced primary care models and provides citations on whether or not health care savings have been achieved.

Description: This article discusses new opportunities for states to waive certain marketplace requirements of the Patient Protection and Affordable Care Act. The article focuses on specific opportunities for states and the role that actuaries will play.