2024 Health Meeting VIRTUAL - Session 6C: Improving Health Outcomes by Focusing on Cost Effectiveness Rather than Costs 7.25.24 Recording

Cost is a key outcome metric used by actuaries and others to determine the value of a benefit or program in health insurance. However, typically, costs assessed include only the direct costs of the program, not any indirect costs or savings, such as those associated with reduced spending on other services. In addition, focusing solely on costs ignores other important outcomes, such as improved health. The adoption of benefits that would improve health outcomes may be inhibited as a result. In this session, panelists will discuss the pitfalls of using a cost-only approach and how to consider cost-effectiveness in health insurance benefit design decision-making. Shifting the focus may help improve health equity and overall health outcomes. Attendees will gain insight into the concept of cost-effectiveness as a critical skill for actuaries and develop an understanding of how incorporating not just the dollar impact but also the quality impact into the evaluation of benefits and programs leads to a more comprehensive assessment of their value.