This page describes the changes made to the Specialty syllabus for the Spring 2021 exam.

There were several changes made to the Specialty syllabus for the Spring 2021 exam, and they are discussed below.

Three articles and one study note were added:

  • GHS-129-21: Effects of a Population Health Community-Based Palliative Care Program on Cost and Utilization
    • This paper reviews a propensity score adjusted study on Medicare Advantage patients who were at risk of overmedicalized death
    • The methods used in the study follow similar techniques used in Duncan’s Managing and Evaluating Healthcare Intervention Programs text
    • Results showed cost and utilization reduction from the intervention program
  • Valuation of Care Management Vendors
    • This paper discusses how to evaluate venders that offer a particular care management program
    • The concepts are all similar to the ones already discussed in the Duncan text
    • The concepts are streamlined at a very high level without any concrete examples to show how the ideas were implemented
    • Exam questions coming from this paper will probably be list/describe, and any calculations would be an “assess the ROI of a vendor’s program” kind of question
  • Risk Considerations for Innovative Products – A Case Study of the Long-Term Care Industry
    • This paper looks at LTC insurance as a lens for insight to teach other health and welfare actuaries to deal with the adversities that arise with new insurance products
    • Some of this article is the story of LTC insurance and then the rest falls more in line with its learning objective: evaluate health insurance organization risk and mitigation strategies
    • They talk about risks that arose from the industry and how those risks have been managed
    • A lot of similar concepts were discussed in a study note that was just removed from the syllabus, GHS-127-19, and thus this paper simply adds to the syllabus more general context to the LTC market and how ERM plays a role
  • Creating Stability in Unstable Times – A Look at Risk Adjustment and Market Stabilization
    • This paper discusses the instability of the individual (medical) health insurance market and how aspects of the ACA are helping to stabilize the market
    • HHS-HCC risk adjustment is a major theme throughout the paper
    • A study of the individual market in Nevada is used to illustrate how some ACA provisions are impacting profits, and general trends that are emerging

Finally, the following items were removed from the syllabus:

  • GHS-127-19 – The Risks of Pricing New Insurance Products – The Case of Long-Term Care