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: 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: Article on the history of the Long Term Care Discussion Group, a Washington DC-based venue for discussing long-term care and related issues for over 20 years.

Description: Read the November 26 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: The collective investment in transforming the life insurance proposition exceeds anything seen in the last thirty years — a working lifetime. As one would expect, reinsurers are playing a major role. The past five years have seen global reinsurers raise the bar on client experience to new levels, while also investing, expanding and re-organizing to support the transformation of the primary insurance industry, and in so doing also their own.

Description: Read the November 14 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: The SOA Reinsurance Research Section is seeking proposals on Mortality Improvement Independ – Independent Analysis. Mortality improvement is an important assumption for projecting future liability cashflows and has a material financial impact on a company. Mortality improvement is a hot topic in the industry and companies show significant interest in understanding the key factors that differentiate mortality improvement. The focus of this research is to gain a better understanding of the main drivers of mortality improvement:

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: Read the October 2019 issues of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities. This is the second digital-only issue of the newsletter.