In the first quarter of 2018, we saw the impact of new regulations and policies that are changing health care in a big way. This newsletter contains need-to-know information that I hope makes your job easier to stay on top of these changes. Feel free to email me at [email protected] if you have questions or comments.
Come see me at the Society of Actuaries Health Meeting in Austin. I'd love to see you! I will be speaking at four sessions. More information is here.
Lewis & Ellis Marks Five Decades
Actuarial Prowess with a Big Footprint
Best's Review once again ranked Lewis & Ellis among the top health actuarial firms in the U.S. and Canada. When Bill Lewis and Dan Ellis started the company in 1968, they had clear ideas on how to achieve success.
Here's our story:
Policy and regulatory changes from Washington have dramatically changed how insurers participate in the federal marketplace. Health insurers are deciding how to proceed. Read the analysis.
Are Short-Term Health Plans a Good Idea?
A Trump proposal would extend short-term health care plans to 364 days. Supporters think this is a good idea in light of the growing "gig economy." Others believe the change will hurt the viability of the ACA's individual market. Get the details
here.
Coverage for One and All
Insight into the Individual Market
Long before the ACA, several states tried guaranteed issue health care. Can federal lawmakers learn from their experience?
This is the fifth white paper in a series entitled "Commercial Health Care: What's Next?", a strategic initiative launched last year by the Society of Actuaries, and it sheds new light on our understanding of the Individual Mandate.Read it here.
Podcasts
Funding health care costs for
individuals with pre-existing conditions is a sensitive topic. Two actuaries offer a simple reform proposal that could help save the Affordable Care Act's individual market.
Cost-sharing reduction payments by the federal government are a hot-button issue with a troubled legislative history. I interviewed actuary and CSR expert Dean Ratzlaff, who has some practical ideas on how to move forward in this uncertain landscape. Listen.
What gets in the way of maximizing the value of an
integrated delivery system? The financial interests of the payer side and provider side are not aligned.
Actuary Karan Rustagi proposes a solution.
As the health care industry moves towards value-base care, many arrangements have some form of a diagnosis-based risk adjustment. How can actuaries help educate providers? The discussion covers the CMS-HCC Part C risk adjustment model. Listen.
