Description: This paper discusses health care developments in Canada current to 1961. From Transactions of Society of Actuaries 1961, Vol. 13, No. 37.

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: 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: This session discusses demographics of the uninsured & underinsured, needed core benefits, funding uncompensated care, state pools for high risk and near poor, the Massachusetts system, and the Kennedy-Waxman federal bills. From Record of the Society of Actuaries 1988 Vol. 14, No. 4B.

Description: This session discussion is about AIDS: Experience, trends and projections, medical and disability points of view, pricing, underwriting and epidemiologic implications and results of survey on current practices. From Record of Society of Actuaries Vol. 18, No. 1B.

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: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: This report evaluates alternative payment models that potentially could be instituted by healthcare payers and manufacturers.

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