Casualty Actuarial Society

Research

CAS Committee on Health and Managed Care Issues Announces 1999 Call for Papers Managed Care – Practical Casualty Applications

November 17, 1998

The Casualty Actuarial Society is pleased to extend a call for papers on managed care topics. The purpose of this Call Paper Program is to encourage communication of work being done in casualty actuarial areas impacted by managed care. Specifically, the focus of this Call is on techniques and methodologies used to incorporate the impact of managed care into casualty work products.

A prize will be awarded for the best submission, and some authors may be asked to present their papers at the 1999 Health and Managed Care Issues Special Interest Seminar, October 18-19, 1999. Both CAS members and non-members are invited to submit proposals.

Actuaries working with casualty products ranging from automobile and workers compensation to medical malpractice and provider excess liability are being asked to contemplate the impact of managed care in their work products. However, limited literature exists on ratemaking or reserving adjustments for managed care. We welcome all papers on managed care topics, but prefer papers that focus on practical approaches to contemplating the impact of managed care. We have listed topics that our Committee has identified as key areas for expansion of the existing body of literature. This list is by no means exhaustive and we will consider additional relevant topics.

  • Impact of Managed Care on Losses and Loss Adjustment Expenses
    • Comparisons of the initial and long term costs/benefits of different types of Managed Care Organizations (MCOs).
    • Impact of different provider/payor relationships on loss costs.
    • Impact of occupational injury programs.
    • Impact on automobile personal injury protection loss costs.
    • Impact on catastrophic workers compensation and general liability claims.
    • Approaches to retrospective assessment of program effectiveness.
    • Impact on loss reporting and/or payout patterns.
    • Impact of MCO utilization restrictions on coverages and costs.
    • Impact of specialty provider networks and treatments (e.g., chiropractors, physical therapists, pharmacy, dental).
    • Analysis of medical care cost by medical treatment type.
    • Analysis of costs and benefits of third party administrators on expenses and losses.
    • Impact of integrated medical and/or integrated disability products on expected losses.
  • Impact of Managed Care on Medical Professional Liability Insurance Coverages
    • New Professional Liability Exposures
    • Development of New Medical Malpractice Exposure Bases
    • The relationship between network quality measures and liability claims.
    • Impact of ERISA erosion.
    • Impact on Employment Related Practices Liability.
    • Impact and relevance of demographics and geography as cost drivers for professional liability.
    • Methods to evaluate risk management techniques for medical providers.

Timetable

The following procedures and timetable will apply to the submission of the discussion papers:

  1. By January 15, 1999, authors should submit proposals for their papers including the title, a short description of the topic to be addressed, and the approach that will be taken. Proposals should be submitted to:
  2. Attn: Committee on Health and Managed Care Issues
    Casualty Actuarial Society
    1100 North Glebe Road, Suite 600
    Arlington, VA 22201
    Fax: (703) 276 3108
    E-mail:office@casact.org

  3. By February 1, 1999, the Committee will make a decision on all proposals. The number of accepted proposals may be limited. The Committee will contact authors regarding their proposals, assign a Committee member to work with each author and monitor the paper’s progress. By mutual agreement, the author and the assigned Committee member will establish a schedule for the production of interim drafts.
  4. By June 1, 1999, a first draft of the completed paper will be submitted to the assigned Committee member for review.
  5. By July 1, 1999, all comments on the first draft will have been forwarded to the author.
  6. By August 15, 1999, the completed paper and a 200-word abstract must be received by the Committee on Health and Managed Care Issues for their review. Authors will have received further instructions from the Committee of the name and address of the Committee member to receive the completed paper. Each paper will be screened by the Committee to assure that it meets minimum standards established by the Committee (relating to relevance of material and quality of exposition). The Committee may require further rewriting of the paper to bring it to an acceptable standard.
  7. By September 1, 1999, all authors will have been notified as to the results of this screening process. Accepted papers will be published.
  8. Authors may be invited to present their papers at the CAS Special Interest Seminar on Health and Managed Care Issues, scheduled for October 18-19, 1999 in Hilton Head, South Carolina.
  9. Prizes of up to a total of $2,500 are available for the best papers submitted in response to the call. Prizes awarded will be presented at the 1999 Special Interest Seminar on Health and Managed Care Issues. The best paper or papers will be selected by a review committee that will judge the papers anonymously. The criteria for evaluation will reflect:
    • Originality of ideas
    • Clarity of presentation
    • Contribution to the existing literature on managed care
    • Thoroughness of analysis
  10. Papers must be no more than 10,000 words, and should be prepared in accordance with theGuides for the Submission of Papers in the 1998 CAS Yearbook. In addition to a hard copy of the paper, the author will be required to provide an electronic copy of the paper on diskette, and will be asked to sign a "Release and License" form allowing the CAS to publish the paper.

It is also hoped that the authors will also submit their papers for publication in the Proceedings in accordance with the procedures in the Yearbook. However, acceptance of a discussion paper for this call does not guarantee its acceptance for publication in the Proceedings. As noted above, the Committee members will actively work with the authors to expedite the preparation process.

The Committee on Health and Managed Care Issues looks forward to receiving proposals in response to the call, and is happy to respond to inquiries from interested parties. Questions concerning the Call may be addressed to Pamela Sealand Reale at her CAS Yearbook address.