Description: "Most patients enter the health care system through their primary care provider or through the Emergency Room or an Urgent Care Center. How an emergency room is structured, managed, and provides care is one of the major forces impacting the total cost of care. Yet it is often an after-thought and ignored by both health plans and health systems. In reality, the structured introduction of efficient practices can substantially reduce the quantity and cost of health care services. Further explore useful information to better understand and see how there are still substantial opportunities for improvement."

Description: This article is a summary of the SOA Research Institute report published in April 2023 on Megatrends Impacting the Future of Retirement Plans.

Description: Traditional predictive tools are not built to deal with the variability the world currently faces. The COVID-19 pandemic amounts to a prolonged black swan event, for which one must look past conventional assessments to arrive at any level of confident predictions. Behavioral analysis factors for biases and heuristics designed specifically for uncertain evolutionary contexts, and which are the primary drivers of market participants’ decisions at present. Through understanding the most likely behaviors of individuals, it becomes possible to arrive at an aggregate understanding of market outcomes.

Description: Come discuss how reinsurers can work side by side with insurer to better develop products, and lift in the areas that reinsurers have more experience, help matching products with distributions (or vice versa) and provide advanced technologies associated with tools and software. The speakers will also present Direct to Consumer plan from various points of view, i.e., distributors, carriers, and reinsurers. Some case studies will also be presented where traditional reinsurers and asset-intensive reinsurers helped insurers bring products to life.

Description: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: MACRA not only impact providers, it will impact the entire healthcare market. MACRA published studies and commentary to date have primarily focused on providers, with the majority of the information addressing the impacts to clinicians. However, our investigation indicates MACRA has far reaching impacts to payers as well as providers. MACRA is impacting each geographic market and line of business in a unique way, and health payers will have multiple strategic decisions to consider given the changing market dynamics.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: "Examine the impact of traditional deductibles on health care equity and the need for innovative plan designs. You will learn about the limitations of consumer-driven health care costs broadly today, as well as alternative cost-sharing approaches that have been successful in driving consumerism without exposing members to high costs. By attending the session, you will be able to: Have a clearer understanding of the issues surrounding deductibles Be equipped with practical ideas for creating more equitable and effective cost-sharing solutions Assess the feasibility and potential impact of implementing these solutions for your own organization"

Description: Numerous behavioral finance theories have emerged in recent years, many of which apply to insurance. The presenters look at key theories and their use in explaining, predicting and inducing behavior from the perspective of the health insurance customer journey.

Description: This article is part of a 2 part series on real options analysis (ROA). Before you can understand the limitations of ROA, you must first understand the difference between risk and uncertainty. This article goes into detail explaining the vast differences between the two phenomena.