SOA Blog

‘Tis the season for healthcare conversations

It is that time of year again in health care – open enrollment for benefit plans at a significant portion of American businesses. Not exactly as enthralling as the holiday season, but important to most workers nonetheless.

With thoughts of premiums, deductibles and networks percolating in November, the Society of Actuaries will cover a number of health care issues on the blog this month. Stay tuned for links to charts that show the state of health care, question-and-answer posts with industry experts and a review of the New York Times best-selling book Health Care Will Not Reform Itself.

For now, we will highlight some of the trending topics online that are pertinent for those trying to manage health care risks for the broader economy, for an employer or for a provider of health care services.

• Constitutionality of health care reform – On November 8, the U.S. Court of Appeals for the District of Columbia upheld the constitutionality of the Patient Protection and Affordable Care Act. Proponents and critics quickly, and vociferously, provided commentary on Twitter.

• The definition of “essential” – The Department of Health and Human Services is hosting regional listening sessions to clarify what should be considered an essential health benefit. A TIME Magazine blog post put the importance of this definition in context by suggesting, “the success of the entire law depends on finding the right balance between how comprehensive required coverage will be and how affordable it will be.”

• Accountable care organizations (ACOs) – The Patient Protection and Affordable Care Act mandated this network of healthcare providers take responsibility for the overall care of Medicare beneficiaries beginning January 2012. As the new year approaches, online search traffic for “accountable care organizations” is on the rise for the first time since the spring.

If you have any questions about risk management in health care, feel free to leave them in the comments section and an actuary with expertise in that area will jump in with some thoughts.

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