Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: Presenters discuss the differences between patient treatment protocols and length-of-stay guidelines, and some of the issues that payers confronted as the protocols were implemented. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: A review of the academic article "Health Insurance for ‘Humans’: Information Frictions, Plan Choice, and Consumer Welfare."

Description: This article describes the results of three years of work by Blue Shield of California to collaborate with hospitals and physician organizations to reduce cost and improve quality for commercial populations in targeted geographies.

Description: This session is about structuring an HMO, rating, financing & solvency and underwriting. From Record of Society of Actuaries 1979 Vol. 5, No. 4.

Description: This session discusses defined-contribution plans as a method for employers to manage costs. Panelists discuss product designs and strategies as well as the impact on the health insurance market and third party administration business. Included is a discussion on e-health insurance. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 59

Description: This article describes a method that can be useful when re-fitting a risk score model to a population of only moderate size. Learn how to use concepts like ridge regression to train a model with partial credibility.