Description: The measure of a health-care provider's quality and efficiency can be used to reward or penalize the provider through reimbursement strategies and plan designs. Panelists discuss the measures that are becoming available. From the 2002 Record of Society of Actuaries, Volume 28, No. 2. Session 24PD of the San Francisco Spring Meeting.

Description: Experts discuss new strategies related to provider contracting and network management. Topics include various reimbursement approaches and risk-sharing arrangements, unique risk arrangements for certain provider specialties, unique risk managements for specific diseases, and the role of care management/care coordinators. From the 2002 Record of Society of Actuaries, Volume 28, No. 2. Session 59PD of the San Francisco Spring Meeting.

Description: This session will teach the ABCs of HMOs and PHOs. Topics include provider networks, contracting, utilization controls, integrated health care, From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Presented at June 1996 Spring Meeting. This discussion looks at redirecting the traditional role of the actuary into new areas such as working with doctors to deal with medical management issues, dealing and negotiating with providers and how to help the company develop a provider payment strategy. Employers negotiating directly with providers is also discussed.

Description: This session discusses HMOs: do they manage health better, do provider financial incentives reduce quality, do HMOs profit from shadow pricing, and do they attract better risk. From Record of Society of Actuaries Vol. 16, No. 1.

Description: This session discussion is about managed mental health, substance abuse, prescription drug, and vision benefits. From Record of Society of Actuaries Vol. 19, No. 1B.

Description: Panelists discuss the various types of risks in health insurance and health-care delivery, and various types of risk-absorption mechanisms for sharing these risks among providers, insurers, employers, and employees. In addition, they address the management of the risk from a corporate perspective, which will include bottom-line earnings and marketing goals and objectives. From the 1987 Record of Society of Actuaries, Vol. 13, No. 4B.

Description: This session discussion is about employer mandates, state regulations [retirement communities & HMOs, NAIC rate regulation exposure draft ], relations with regulators and relations with health care providers. From Record of the Society of Actuaries Vol. 15, No. 3A.

Description: Discusses health-care-cost reimbursement structures, from the facility/hospital perspective and the professional/doctor perspective. Also discusses risk-absorption methods. From the 1987 Record of Society of Actuaries, Vol. 13, No. 1.

Description: This session discussion is about high risk health pools: comparison of plans, what is working, experience and public policy considerations. From Record of Society of Actuaries Vol. 16, No. 1.