Description: A panel of actuaries and clinical consultants at this session of the SOA 2003 Vancouver Spring Meeting provides an assessment of current and future applications of predictive modeling techniques in the health arena. A practical example of risk adjustment, discussion of the clinical use of this technique, and applications in underwriting are discussed.

Description: As value-based solutions evolve, it is more important than ever for providers to understand their performance and how it is measured, along with the drivers of success. Presenters will cover the evolution of past risk-transfer programs such as Medicare Shared Savings Program and Next Generation ACO. They will also discuss the new Primary Care First and Direct Contracting models recently announced by CMS.

Description: One of the Health Section's key focuses in 2019 is Initiative 18/11. Last year the SOA joined forces with the Kaiser Family Foundation (KFF) and the Healthcare Financial Management Association (HFMA) to answer the nagging question: “What can we do about the cost of healthcare?” A steering group has been formed to lead a research project as to what managed care companies can do to reduce costs without sacrificing quality. The project [called Managed Care 3.0 in the 18/11 paper] will examine historical models that have worked as well as investigate the impact that new technologies and care models may have on cost and quality, with the goal of better understanding the current environment and identify­ing potential risks and opportunities.

Description: The panel will provide an update on current developments in the financial transfer of risk under alternative managed care arrangements. The panel will also discuss the emerging issues with respect to capitation arrangements. From the Record of the Society of Actuaries, Vol. 21, No. 4a.

Description: This session discussion is about the trends and proliferation, the impact, the horizon, genetic research, considerations for containing utilization of various procedures and technology. From Record of Society of Actuaries Vol. 17, No. 3.

Description: This session 62 PD of the Las Vegas Spring Meeting focuses on provider excess reinsurance, which is an excess of loss coverage for providers assuming risk under various forms of managed care arrangements, such as HMOs, PPOs, and Medicare/Medicaid. From Record of Society of Actuaries, Volume 26, No. 3.

Description: The presenters will provide insights into fraud and abuse risk in the health insurance industry, including an examination of traditional and predictive modeling techniques for both prevention and detection. Emphasis will be placed on current and emerging risks. Canadian examples and perspectives will be offered, but the applications for attendees to use in practice are non-nation specific.

Description: Representatives of various health care professions will address issues such as falling hospital occupancy rates and a growing shortage of primary care physicians. The presenters will then discuss the short-term and long-term effects of these issues on the health care delivery systems on North America. From the Record of the Society of Actuaries, Vol. 21, No. 3b.

Description: 2002 Valuation Actuary Symposium, Lake Buena Vista, FL. Four key processes are critical to a merger and acquisition transaction: due diligence, negotiation, integration planning and implementation. The panelists discussed how these processes apply to transactions that involve the health area.

Description: This session from the 1984 SOA Atlanta Meeting reveiws executive compensation focusing on retirement, disability and survivor benefits provided to corporate executives above those offered to other employees and the techniques to fund these programs.