« Regulators Clash With Actuaries Over Reserves | Main | The Hartford Brings 'Quote Marine,' the new eSubmission Tool, to Builders Risk Insurance Coverage; Agents, armed with a trusty mouse and keypad, now can place builders risk accounts, even bind a builder, in minutes. »
December 08, 2004
Society of Actuaries and Lotter Actuarial Partners Announce Publication of First Three Papers in a Series of Studies on Disease Management
The Society of Actuaries' Health Section, in partnership with Lotter Actuarial Partners, Inc., has published the first three papers in what is expected to be a nine-paper study on financial outcomes measurement and reporting in the Disease Management industry.
As healthcare payers, including, most recently, Centers for Medicare and Medicaid Services, sponsor more programs directed at improving the health and decreasing the cost of those with chronic conditions, actuaries are being called upon more frequently to assess the validity of financial results.
"We are pleased to partner with the Society in this important endeavor," said Ian Duncan, FSA, MAAA, a Partner with Lotter Actuarial Partners in New York, who is leading the project. "We are being asked more and more by clients to provide assessments of financial results. Clients recognize that actuaries are familiar with validation of financial results and can contribute to this developing area of medical management."
The study encompasses the actuarial and measurement issues surrounding care and disease management financial outcomes. A series of nine different papers is planned on both theoretical and applied issues. The overall title is: "Evaluating the Results of Care Management Interventions: Comparative Analysis of Different Outcomes Measures."
The first three papers are: 1) "Programs and Interventions," 2) "Actuarial Issues in Care Management Interventions," and 3) "Understanding the Economics of Care Management." Each is now available on the SOA website at:
http://www.soa.org/ccm/content/areas-of-practice/health/research/eval-results-care-man-int/
Due to its length, this URL may need to be copied/pasted into your Internet browser's address field. Remove the extra space if one exists.
Future papers, including two practical applications ("A Comparative Analysis of Chronic and Non-Chronic Population Trends" and "Practical Application of Different Outcomes Measurement Methodologies"), will be posted on the site as they are published by the SOA. The practical application of measurement methodologies is being performed in conjunction with Health Dialog, a Boston-based Care Management Organization, using claims experience of Highmark Inc., a Pittsburgh-based health insurance company.
"This is a timely project for the SOA's Health Section," said Bryan Miller, Vice President and Chief Actuary of Blue Cross and Blue Shield of Kansas City, and chair of the Project Oversight Group. "The significant increase in disease management programs has created a need for vendors, carriers and others to have a greater understanding of appropriate evaluation techniques. We are pleased to contribute to the disease management discussion through the review and publication of these papers."
Lotter Actuarial Partners is an actuarial consulting firm specializing in risk management, health insurance and reinsurance brokerage, with a practice in disease management and health risk prediction.
The Society of Actuaries (SOA) is a nonprofit educational, research, and professional society of 17,000 members who are involved in the modeling and management of financial risk and contingent events. The mission of the SOA is to advance actuarial knowledge and to enhance the ability of actuaries to provide expert advice and relevant solutions for financial, business, and societal problems involving uncertain future events.
The purpose of the SOA's Health Section shall be to encourage and to facilitate the professional development of its members through activities such as meetings, seminars, research studies, and the generation and dissemination of literature in the field of health insurance and health benefit plans.
Posted by Tom Troceen