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This paper provides a high-level guide on risk adjustment within the broader scope of four Centers for Medicare and Medicaid Services episode-based payment models.

This article discusses why the coverage of preexisting conditions is a key issue in health insurance, particularly with respect to affordability and sustainability, and outlines varying approaches to addressing it.

If cost containment is the goal, then what should be the means to that end? While price controls may seem like a solution, they are likely to further weigh down a healthcare system that is already heavy with perverse incentives.

Several of the reform bills in Congress share a common theme: A move away from the rating and underwriting techniques, and a move toward an individual mandate where all people are required to obtain health insurance.

A new paper published by Sen. Max Baucus over Labor Day weekend, Framework for Comprehensive Health Reform, introduces a new concept to the healthcare reform discussion special policies for "young invincibles" the healthier, younger lives that have typically not purchased

The many available choices in the U.S. commercial insurance market, combined with the unique complexities of the current healthcare market, create a complex cause and effect matrix that is reflected in a range of different health plan costs. This paper

This paper illustrates and clarifies some of the intricate interworkings of the complex drivers of health insurance costs and highlights the need for an actuarially sound approach to healthcare reform that can consider these variables alongside one another.