2017年、ミリマンのウェブサイトに発表された記事の中で最も読まれた記事の多くは、ヘルスケアと年金に関するものでした。ヘルスケア制度改革の可能性は、ミリマンのコンサルタントが相次いで記事を書くきっかけとなり、トップ15のうち7つがヘルスケア関連記事となりました。しかしInsurTechの台頭およびIFRS 17の課題を含むそれ以外の記事も、こうした関心を集めた分野の記事に割り込みました。以下に2017年に世界で最も読まれた15の記事のリストを示します。
G100 discount rates , By Craig McCulloch and Danny Quant
Monthly reports on Group of 100 discount rates
Milliman Medical Index , By Christopher Girod, Susan Hart, and Scott Weltz
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.
Pension Funding Index , By Zorast Wadia and Charles Clark
Monthly reports on the funded status of the 100 largest corporate defined benefit pension plans as measured by the Milliman 100 Pension Funding Index.
Corporate Pension Funding Study , By Zorast Wadia, Alan Perry, and Charles Clark
The 100 largest corporate defined benefit pension plans finished 2016 with pension assets of $1.395 trillion and projected benefit obligations of $1.718 trillion.
Impact of the transition from RAPS to EDS on Medicare Advantage risk scores , By Deana Bell, David Koenig, and Charlie Mills
A study of how the transition from Risk Adjustment Processing System data to Encounter Data System data is affecting the payment year 2016 risk scores and revenue for Medicare Advantage, also known as Medicare Part C.
Summary of individual market enrollment and Affordable Care Act subsidies , By Paul Houchens, Jason Clarkson, and Zachary Fohl
A profile of the individual health insurance market for each state along with the District of Columbia, summarizing insurer financials, marketplace enrollment, and federal assistance provided to households purchasing insurance coverage through the insurance marketplaces, incorporating recently released data from the 2017 open enrollment period.
2017 Public Pension Funding Study , By Rebecca Sielman
An annual exploration of the funded status of the 100 largest U.S. public pension plans.
The employer stop-loss insurance marketplace since the Affordable Care Act , By Mehb Khoja
The Affordable Care Act has considerably increased the need for and expanded employer interest in stop-loss coverage.
InsurTech: Innovation in the P&C insurance space , By Thomas Ryan
To determine what may be the hype curve for InsurTech, it’s valuable to pause and survey the current landscape.
Overview and practical considerations of the new insurance contract standard: IFRS 17 , By Gillian Tucker and Andrew Kay
This briefing note discusses some of the challenges companies will face when adopting and applying IFRS 17.
Building blocks: Block grants, per capita caps, and Medicaid reform , By Justin Birrell, Jennifer Gerstorff, Nicholas Johnson, and Brad Armstrong
Understanding the implications of Republican Medicaid reform proposals requires consideration of several factors.
Figure 2: Potential risk by funding source
| Funding scenarios | |||
| Funding attribute | Current | Block grant | Per capita cap |
| Funding limit | None, as long as regulatory requirements are met. | Established in advance, unchanged with population growth or environmental factors. | Established in advance, varies based on population size, but unchanged for environmental factors. |
| State vs. federal medical growth rate | Consistent growth rates. | Federal growth defined in advance. State growth leveraged based on overall growth. | Federal growth is mitigated. State growth may be leveraged if cost per enrollee is more than projected. |
| Enrollment mix change risk | Federal risk varies by FMAP: if populations with higher federal match increase at a faster rate than the overall population, state share of bill is lower. For states with low/no expansion enrollment, match is relatively steady. | Federal government transfers risk to states. | Depends on structure. If cap is per capita on an aid category basis, then risk is similar to current. If not based on aid category, mix of members by aid category could negatively impact states as population groups age and LTSS become more prevalent. |
| Enrollment growth mix | Consistent risk state versus federal. | Federal government transfers risk to states. | Consistent risk state versus federal, as long as new members don't have higher-than-average cost. |
Effective employee communication: The benefits of best practices , By Jessica Gonchar, Heidi tenBroek, and Sharon Stocker
Communications is vital to inform and influence how employees think about their benefits, workplace, and employer.
MACRA and Medicare Advantage plans: Synergies and potential opportunities , By Christopher Kunkel, Drew Osborne, Lynn Dong, Michael Polakowski, Noah Champagne, and Charlie Mills
While MACRA primarily affects Part B clinicians, there are numerous implications, synergies, and opportunities for Medicare Advantage plans.
Figure 1 – 2015 Medicare expenditures
The American Health Care Act , By Jason Karcher
The American Health Care Act would impose several reforms on the commercial market, repeal several taxes introduced under the Patient Protection and Affordable Care Act, and fundamentally reform the Medicaid funding process while allowing a glide path for the end of enhanced federal funding for the Medicaid expansion.
Multiemployer Pension Funding Study , By Kevin Campe
This study updates the estimated funded status of all U.S. multiemployer plans as of June 30, 2017, showing the change in funding levels from December 31, 2016.