Archive of Healthcare

SOA Health Section Rolls Out Valuable Member Benefit: Access to Health Affairs Articles Thumbnail

SOA Health Section Rolls Out Valuable Member Benefit: Access to Health Affairs Articles

Now get unrestricted access to numerous health, health care and policy articles with important information you need to know about the latest health issues and trends via your free Health Affairs onlin

Read MoreLeave a Comment
ACOs and Gainsharing:  What was old is new again Thumbnail

ACOs and Gainsharing: What was old is new again

by Jim Toole, managing director, life & health, FTI Consulting Accountable Care Organizations (ACOs) bring hospitals and physicians together as a risk bearing entity, aligning incentives betwee

Read MoreLeave a Comment
20Apr2012
Actuaries: Turn wellness from a dream into a real business advantage Thumbnail

Actuaries: Turn wellness from a dream into a real business advantage

by Andrew Sykes, Health at Work Wellness Actuaries Hardly a day goes by without another report of the possible and positive returns on investment available from wellness programs. Yet, with few exc

Read MoreView Comments (2)
11Apr2012
Fiscal Effects of the Affordable Care Act Thumbnail

Fiscal Effects of the Affordable Care Act

by Ian Duncan, University of California - Santa Barbara An important new paper by Charles Blahous of George Mason University (and a Social Security and Medicare Trustee) has just been published. 

Read MoreLeave a Comment
Actuarial principles at play in Supreme Court health care case Thumbnail

Actuarial principles at play in Supreme Court health care case

by Sara Teppema, SOA senior staff fellow, practice research On Tuesday of this week, the U.S. Supreme Court wrapped up the second of four sets of arguments in the historic case involving the 2010

Read MoreView Comments (6)
07Mar2012
Author
SOA Blog
Category
Healthcare
Tags
,
Have provider networks and network discounts outlived their value? Thumbnail

Have provider networks and network discounts outlived their value?

by Shiraz Jetha, FSA, CERA, MAAA Provider networks originally started as a way to control patient steerage to network providers in return for price discounts. In other words, lower price for antici

Read MoreView Comments (1)
06Mar2012
Latest national healthcare expenditures Thumbnail

Latest national healthcare expenditures

by Ian Duncan, University of California - Santa Barbara The recent release of National Healthcare Expenditure data for 2010 shows a very slight uptick.  What is more interesting, though, is the lo

Read MoreView Comments (2)
Accountable care organizations: Extending the techniques nationwide Thumbnail

Accountable care organizations: Extending the techniques nationwide

by Greger Vigen, FSA Given rising health costs and continuing uneven quality, major players in the health care industry (hospitals, physician groups, insurance companies and professionals like actu

Read MoreLeave a Comment
Health care costs Thumbnail

Health care costs

by Jim Toole, managing director, life & health, FTI Consulting According to the Office of the Actuary, U.S. health spending grew more slowly in 2009 and 2010 than at any time since Medicare was signed into law.  Driven by the recession, Americans delayed hospital care, avoided emergency room visits, and changed the way they purchased prescription drugs, reducing the growth in health spending close to the rate of the economy overall. Despite this, health insurance premiums grew faster than insurance spending, and the overall margins that insurers enjoyed increased.  Some insurers were charging higher rates to address the uncertainty posed by the PPACA, but in general the costs associated with the changes in law have yet to materialize. Health benefit plan costs rose at rates higher than the rate of spending, squeezing margins and reducing the competitiveness of U.S. businesses internationally.  Businesses responded by pushing more costs to employees, reducing overall benefits and switching to higher deductible plans with lower premiums.  (more…)

Read MoreLeave a Comment
19Jan2012
On the edge of a new age of healthcare financing Thumbnail

On the edge of a new age of healthcare financing

by Ian Duncan, University of California - Santa Barbara When I entered health actuarial work 31 years ago, the absolute cost of health benefits was much lower (although as a percentage of average nominal income the difference is less than is sometimes recognized).  Plans reimbursed allowable expenses for eligible members without much interference. Insurers employed claims payers and actuaries; medical directors were involved in underwriting, if at all. All that has changed with managed care.  The managed care revolution was successful in its early days (zero and even negative trends for HMOs in the mid-1990s) but consumers revolted against the limited choice and trend began its rise.  At the same time there was an explosion of new, life-extending devices and drugs which added to cost. I think we have learned a few things along the way, including the fact that providing consumers with insurance increases consumption (hardly surprising but overlooked in the scramble for reform). We stand on the edge of a new age of healthcare financing, in which the old insurance model is effectively outlawed (no longer can we underwrite, exclude pre-existing conditions or charge a rate appropriate for the risk). I don’t believe that this model will be any more successful than prior models at containing costs, and will lead in

Read MoreView Comments (3)