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The Current State of U.S. Health Care

There are four major types of health care system models globally, as shown in Figure 4. The primary differences in the models include the funding methods, government control … See more

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URL: https://www.theactuarymagazine.org/the-current-state-of-u-s-health-care/

Incremental Changes in U.S. Health Care Coverage

WebA study 10 by Zack Cooper and colleagues that was conducted as part of the fascinating “1% Steps for Health Care Reform” project highlights that while U.S. household income …

Category:  Health Go Health

Addressing Inadequate Health Literacy

WebPhoto: Shutterstock/MOLDOVA. American health care spending is a complex and layered issue. While there is a strong correlation between low health literacy and increased …

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Future of Gene Therapy Funding

WebFuture of Gene Therapy Funding. New curative cell and gene therapies pose several challenges to U.S. health care payers. Treatments such as chimeric antigen receptor …

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Diffusion of Technology in Health Care

WebIn the short term, both emerging health care technologies and the COVID-19 pandemic have primed the health care consumer for using new technologies. Total health …

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The U.S. Health Care Debate

WebEven with that, the uninsured population was nearly cut in half from 2010 to 2016, dropping from 18.2 percent to 10.4 percent. That is nearly 20 million Americans who now have …

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New Rules to Expand Association Health Plans

WebThe Obama administration in 2011 required that health insurance policies sold through an association to individuals must comply with the ACA’s individual market reforms, while …

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Federal Regulation of Prescription Drugs in the United States

WebThe federal government does not regulate drug pricing. However, it encourages the development of generic drugs through an abbreviated approval process. For example, …

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Rebates at the Point of Sale

WebIn light of this, payers have considered sharing their rebates with the consumer at the point of sale (POS). The Society of Actuaries’ (SOA’s) Initiative 18|11 is exploring all areas of …

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Putting a Price Tag on Health

WebThe answer may seem obvious, but it is worth reflecting on. Health, as defined by the World Health Organization, is “a state of complete physical, mental and social well-being and …

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The ACA’s Impact on Rural Areas

WebPremium rates in rural regions have increased more substantially than in urban areas. For example, annualized premiums for a family of four enrolled in the lowest-cost silver plan …

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The Road to Developing Critical Illness Insurance Under the New

WebOn Nov. 5, 2020, the Specifications for the Use of Illness Definitions for Critical Illness Insurance (2020 Revised Edition) and the Critical Illness Empirical Incidence Rate …

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The Changing Face of Risk

WebThe 2000 s. On one level, the first decade of the 21 st century was a time when the forces impacting the health insurance market were relatively minor. The regulatory framework …

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Value-based Risk Share

WebOver the years, Geisinger has learned that such arrangements must: Create mutual trust. Rely on GHP for high-quality and timely data and analytics. Have reasonable and …

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Actuaries and Regulators—Successful Collaborators

WebThe role of the appointed actuary exhibits the specific elements critical to collaboration with regulators: ability to rely on professional standards, transparency in reporting and clear …

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Successes of the ACA

WebIn 38 states, insurers added back the cost of CSRs into silver plan premiums based on guidance from state insurance departments. 10 This practice, which has been …

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Managed Care 3.0 Case Studies

WebTo highlight and spur on U.S. health care innovation, the Society of Actuaries (SOA) and the Kaiser Family Foundation Initiative 18|11 team sponsored this Managed Care 3.0 …

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HDHL Medical Insurance in China: Part 2

WebThe article “ HDHL Medical Insurance in China: Part 1 ,” published in August 2021, explored hot topics in the Chinese commercial medical insurance market, including high …

Category:  Medical Go Health

HDHL Medical Insurance in China: Part 1

WebChinese Version. The hottest topics in the commercial medical insurance market in China right now are high-deductible, high-limit medical reimbursement insurance plans (HDHL, …

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