Description: The editor of Health Watch previews the articles in this issue.

Description: This article compares the Prescription Drug Plan (PDP) market to the commercial individual market exchanges included in the Affordable Care Act. PDP carrier actions to date could help predict certain aspects of the exchange market.

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: Recap of content contained in the January 2014 issue of the Health Watch newsletter.

Description: The US Preventive Services Task Force (USPSTF) requires that essential benefits include "intensive behavioral counseling" for overweight or obese individuals with any other cardiovascular disease risk factors. These requirements can be met through online digital programs that meet the clinical standards of the recognized Diabetes Prevention Program (DPP). This new branch of medicine-digital therapeutics-holds the key to delivering lifesaving interventions to those who need them the most. Omada Health’s Prevent is an example of one innovative product which has successfully translated behavioral interventions like DPP to an online setting. Sean Duffy focused on small-group support, personal health coaching, personalized and engaging design, DPP curriculum adherence and progress tracking-leveraging unique aspects of technology to enhance key elements of successful behavioral interventions. These scalable solutions can bene fit multiple players within the managed care ecosystem and are being seeded by health plan venture investments to help bend the cost curve across the industry.

Description: The article describes the changes to payment structures as of 1/1/2017 and their influence to Medicare Supplement that will be happening as of 1/1/2020.

Description: The article describes the Health Sections strategic initiative for Public Health and the role of the actuary.

Description: Actuaries can apply their experience helping health plans lower costs and premiums within the new world of provider-led accountable care organizations.

Description: Interview with leader Shari Westerfield.

Description: Financial reconciliation is critical to a successful Medicare Advantage (MA) bid. Reconciliation should be routinely revisited as new information arises.