Description: This is a discussion on group life and health products under conditions of inflation. It specifically highlights the development of alternative delivery systems such as Health Maintenance Organizations, the potential for further computerization of claim and record keeping, viability of new areas of coverage such as dental & vision and legal benefits, self-funding and administrative services only mechanisms, and the effect of inflation. From Record of the Society of Actuaries 1982, Volume 8, No. 1.

Description: Beginning with the 2019 Benefit Year, CMS (the Centers for Medicare and Medicaid Services) has provided guidance that allows Medicare Advantage Plan Sponsors much greater flexibility in tailoring benefits to promote clinical, care management, and financial goals. The guidance allows for a broader menu of supplemental benefits and also enables plans to target benefit enhancements to beneficiaries afflicted with specific disease states. This session explores the ramifications of the policy changes on Plan Sponsors and beneficiaries, and discusses the different ways that Plan Sponsors are taking advantage of the additional flexibility.

Description: Telehealth enables the delivery of health care services to patients that are not in the same location as providers. Over the past decade, telehealth has been used increasingly to complement face-to-face patient encounters, and is particularly important to addressing health care needs in rural areas. Recent regulatory catalysts, particularly in the Medicare Advantage program, have served to elevate the visibility and importance of telehealth in the overall health care delivery system. Starting in 2020, Medicare Advantage plans can offer any clinically appropriate physician services through telehealth as part of the standard Medicare benefit. Network adequacy standards can also be met via telehealth providers under certain programs. This presentation will cover the basics of what constitutes telehealth, and provide tangible demonstrations of telehealth technology (simulating variations mediums through which services are delivered). We will cover the what, the why, and the where (anywhere) of telehealth in 2020.

Description: In this presentation, Richard D. Lamm, former Governor of Colorado and currently Director of the Center for Public Policy and Contemporary Issues at the University of Denver, talks about the increasing costs of health care and why the miracles of American medicine have simply outpaced our ability to pay. From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This session is about the impact of health-care reform on supplemental health insurance plans such as Medicare Supplement, Hospital, Cancer, etc. The session will also explore new opportunities for supplementary markets and products. Included is a discussion of the CHAMPUS and FEHBP. From Record of Society of Actuaries Vol. 19, No. 4B.

Description: This panel discussion session focuses on health care alternatives with the objective to improve care and reduce costs. Includes discussion on national programs, managed care

Description: This session discussion is about methods of managing care, what methods have been most effective, experience to date under managed care products, are savings being generated, employer acceptance of managed care products, provider acceptance of managed care products, what will future managed care programs look like. Includes a discussion on utilization review and management, From Record of the Society of Actuaries 1988 Vol. 14, No. 1.

Description: This presentation from Session 8L of the SOA 1996 Colorado Springs Meeting is about analyzing the effectiveness of health care measures as reported by managed care organizations. The discussion focuses on HEDIS, a standardized definition for producing health plan report cards, primarily aimed at health maintenance organizations [HMOs]. From the Record of the Society of Actuaries, Vol. 22, No. 2.

Description: This presentation from Session 86PD of the SOA 1996 Orlando Annual Meeting provides the physician perspective on ethical questions resulting from utilization review decisions infringing on physician decisions in providing health care. From the Record of the Society of Actuaries, Vol. 22, No. 3.

Description: This keynote address at the SOA 1998 Maui II spring meeting is a physician's outlook on the state of medicine in 1998, and what might be expected to change and not change in the short term and long term future.