Healthcare reform reading list: From the ACA archives

• Are health carriers ready to explain the 2018 age curve?

  By Nicholas Krienke, Amy Giese | 16 November 2017

  For the first time since the inception of the Patient Protection and Affordable Care Act in 2014, the federal government is changing the age curve for ages 0 to 20, effective January 1, 2018.

• Individual stop-loss is now optional for Next Generation ACOs

  By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 08 November 2017

  For some Next Generation Accountable Care Organizations, the choice between an annual financial reconciliation based upon capped claims or uncapped claims could have a significant impact.

• Next Generation ACO Program financial results for 2016

  By Hugh Larson, Timothy J. Wilder, Annie Man, Coleen Young | 08 November 2017

  This paper describes the financial results of the Next Generation Accountable Care Organizations program.

• The differences are in the details: Considerations for comparing 30-day unplanned readmission rates

  By Maggie Alston, Michele M. Berrios | 17 October 2017

  This article identifies key elements that should be considered when evaluating readmission rates across populations or when comparing readmission rates with different methodologies.

• Healthcare: It’s complicated

  By Hans K. Leida, Lindsy Kotecki | 08 August 2017

  Actuaries have had a front-row seat as healthcare reform has unfolded and are in a unique position to help address the challenges the complex system presents.

• Identifying high-risk members under a Medicaid expansion program: Experience in Indiana

  By W. John Semmens, Christine M. Mytelka, Robert M. Damler | 07 May 2014

  A successful model for states that are seeking a methodology for identifying the medically frail.

• President Obama’s transitional policy for canceled plans

  By Hans K. Leida | 19 November 2013

  The November 14, 2013 announcement that health insurance issuers would be permitted to renew certain canceled health insurance policies has raised new questions for the individual and small group marketplaces in 2014.

• Risk corridors under the ACA

  By Doug Norris, Hans K. Leida, Mary van der Heijde | 01 October 2013

  We dispel some common misconceptions and demonstrate some of the less obvious aspects of the risk corridor program under the ACA.

• Learning from Medicare Advantage and Part D: Lessons for the individual insurance market under ACA

  By Hans K. Leida | 15 August 2013

  Individual insurers can learn lessons from Medicare Advantage and Medicare Part D (MAPD) to help them reduce risk and plan for the future.

• Employer mandate delay: Key considerations for employers

  By Paul R. Houchens | 19 July 2013

  Delay gives some respite, but ACA still requires employers to take action.

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