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: Impact of Technology on Health Care Delivery Systems - Chart 2

Description: Presented at May 2000 Spring Meeting. Discusses trends affecting costs for prescriptions, factors behind these trends, and cost management strategies for both the commercial and Medicare markets.

Description: Recent health-care cost trends have exhibited significant variability by insurer, geographic area and type of benefit. Employers and insurers are increasing co-pays and reimposing managed care provisions. How have these factors affected the measured trend. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 17

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 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.

Description: This session discussion is about AIDS for health actuaries, contract limits, underwriting practices, regulations on underwriting, claim reserving, recent experience and future outlook. From Record of the Society of Actuaries Vol. 15, No. 1.