Description: Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Direct-to-provider contracting is a strategy in which a self-insured entity negotiates a contract directly with a provider of healthcare services rather than through a third-party administrator (TPA), often with the goal of driving value-based care. This article discusses the considerations for employers and providers with direct-to-provider contracting.

Description: 1992 SOA Regional Meeting, Chicago. This discussion is about direct marketing growth in the 1980s, sustaining the growth in the 1990s, regulatory constraints in the 1990s, impact of continuing production cost increases, new product designs, and declining response rate.

Description: Align carrier, agent, and consumer definition(s) of DTC to establish a collective understanding for the affected parties. Understand why a direct-to-consumer approach may be important for carriers’ and distributors’ growth and development goals, tactics and strategies. Use the agreed-upon baseline and understanding of DTC’s importance to establish and agree upon reasonable expectations for its role in marketing, distribution, and product development and performance. Position carriers and distributors together to align sales, marketing and performance expectations and incentives for all parties to increase the possibility of outperforming in (and outside of) the DTC space; design sales, marketing and distribution systems and approaches to meet consumers where they are at; and expand current sales and cultivate new markets to remain relevant and magnify profiles in an ever-changing industry.

Description: Feature article discussing the impact of health care reform on the direct insurance market and the reinsurance market.

Description: Answers to questions that have surfaced with regard to recent trends in the use of psychiatric medications, including relative effectiveness compared to prescribing patterns, drivers of prescribing patterns, classification and indications for recently publicized drugs, role of primary care providers, preventive use ofdementia medications, and new developments in the field.

Description: The interplay between technology and design to create safe, comfortable and thriving environments for aging in place and managing care costs.

Description: Health insurance company assets and liabilities have evolved since the Patient Protection and Affordable Care Act (ACA) was signed into law in March 2010. The ACA fundamentally rearranged how commercial health insurance is funded by integrating federal premium subsidies and pass-throughs together with a marketplace interwoven with transfer payments among stakeholders. The impacts of these programs can be seen in specific accounting items on the balance sheets of health insurance companies over the past 10 years. Their emergence follows three primary trends: (1) balance sheet items tend to be larger and take longer to settle, (2) there are more interactions among items, and (3) the final settlement amounts are more uncertain.

Description: New insurance product concept to cover elder care

Description: Overview of public health (responsibilities, funding, challenges) and discussion of the role actuaries can play in achieving population health goals.

Description: Since health care reform has made accountable care organizations a hot topic, an SOA workgroup is addressing relevant questions, including provider risk under various ACO models, limitations of the Medicare model for motivating change in the health care delivery system, strategic priorities, attribution of members, meaurement, and the roles actuaries can play.