- The old and the beautiful: How age and gender affect costs and premiums in commercial health care
By Doug Norris, Hans K. Leida, Erica Rode, Travis J. Gray | 08 June 2017
Age/gender rating is an area in which actuarial considerations are often in direct tension with social or public policy considerations.
- Reinsurance and high-risk pools: Past, present, and future role in the individual health insurance market
By Fritz Busch, Paul R. Houchens | 06 June 2017
This paper examines the historical uses of high-risk pools (HRPs) prior to the implementation of the Patient Protection and Affordable Care Act (ACA), the role of reinsurance under the ACA, the proposed usage of reinsurance and HRPs under the American Health Care Act, and considerations for states examining the creation and deployment of these types of mechanisms.
- 2017 Milliman Medical Index
By Christopher S. Girod, Susan K. Hart, Scott A. Weltz | 16 May 2017
In 2017, the cost of healthcare for a typical American family of four covered by an average employer-sponsored preferred provider organization plan is $26,944, according to the Milliman Medical Index.
- Milliman RBRVS for Hospitals
By William J. Fox, Edward Jhu, Charlie Mills, Kevin Frodsham | 27 April 2017
The Milliman RBRVS for Hospitals™ Fee Schedule provides a simple solution for comparing hospital contractual allowed amounts, billed charge master levels, relative efficiency, and patient mix differences.
- Provider price transparency
By Shyam Kolli | 21 March 2017
This paper explores what price transparency means in the healthcare market, the forces driving the need for price transparency, challenges and uses of price transparency, and potential ways in which transparency can be improved for the benefit of consumers and also to be more effective in reducing overall healthcare costs.
- The American Health Care Act: Implications for self-insured employers
By Steven P. May, Bill J. Thompson | 20 March 2017
This paper highlights several elements of the American Health Care Act that affect the employer-sponsored insurance programs of large self-insured employers.
- Are essential health benefits here to stay?
By Rebekah D. Bayram, Barbara Dewey | 17 March 2017
The fate of essential health benefits (EHBs) is uncertain, and what could happen to them is an open question.
- Joint venture health plans: Recent trends and key considerations
By Lynn F. Dong | 13 February 2017
A discussion of recent trends, potential benefits, and considerations for providers and payers considering joint venture health plans.
- What can I afford? Mini-med 2.0 and cost-coverage questions in a post-ACA world
By Nick Ortner | 08 February 2017
What role could mini-medical plans play to address the financial challenges faced by consumers and their plan sponsors in a post-ACA environment?
- Population health management program development: The path to the Triple Aim
By Blaine Miller, Nick Creten | 10 October 2016
This paper outlines a process to define effective population health management programs that will help hospital systems develop a step-by-step approach to care redesign that can improve the health of a population, improve the patient experience, and reduce costs.