Description: In the current value-based care marketplace, there are various reimbursement models that tie payments for care delivery to the quality of the care provided. The purpose is clear – change reimbursement to focus on value by rewarding better outcomes and lower spending. However, implementation it is complex, and many challenges emerge during this transition for both providers and payers.Providers often lack sophisticated actuarial capabilities or clear understanding of the connection between finance and clinical operations. For these reasons, they enter risk arrangements without knowing how to strategically manage and mitigate risks and fully transfer the reimbursement changes into clinical decisions. For payers, a truly viable value-based payment model that rewards the most valuable providers needs a multidisciplinary approach and a solid financial model. Such a model also requires transparency and a clear transitional road map for providers to encourage participation and collaboration. In this session, we will discuss lessons learned through case studies of working with both providers and payers on value-based care issues. We will illustrate the current state of the complex financial structures by presenting examples of value-based financial models, feasibility analyses, and strategies to design a payment model beneficial to both providers and payers. We will also explore the clinical collaboration necessary to make it all work, as well as present some best practice strategies to facilitate strong payer-provider collaboration.

Description: Blockchain technology has the potential to significantly improve the quality of life and overall health of the members of a health system, while also adding to administrative efficiencies. For the first time, we will have access to members’ entire diagnoses and prescription history, consumer behavioral attributes, and other socio-economic determinants which that are valuable inputs to designing appropriate benefits and proper care management plans. Through the blockchain, we will be able to access data not just of the existing members of the health system but also of potential enrollees and new entrants. The data can be accessed by querying the blockchain through a permissioned granted by the member. This information can be very useful in performing feasibility studies for evaluating entry into newer markets and/or newer products, developing customized care plans, and designing efficient value-based contracts. By executing smart contracts on the blockchain, we will be able to achieve administrative efficiencies like never before. The applications of blockchain technology are numerous and ground-breaking. Organizations that do not pay heed to the benefits that blockchain can bring may find themselves left behind as the rest of the industry marches forward in its quest for efficiency and member satisfaction.

Description: Discussion of the ways carriers can deliver a direct to consumer offering in a way that benefits, rather than alienates, the advisor channel.

Description: In this article, we describe new approaches to long-term care financing that rely on home equity release and we address several of the challenges mentioned above. While these approaches stand to help expand the potential for long-term care financing to middle-class Americans, even these approaches don’t address a large swath of the U.S. with less privilege, who have little or no home equity. We will discuss the product design, marketing, pricing and risk management of these new approaches and potential behavioral factors that should be considered. The article builds on a growing body of academic research to which the authors have actively contributed. We want to share the key insights of this international work in market research, economics, and actuarial studies to stimulate more research in this area.

Description: Most industry professionals acknowledge that funding retirement needs will almost always require disciplined savings over a period of decades. Today, we are less than 30 years from the second half of the 21st Century. However, a majority of the Millennial and Gen Z generations are either not eligible for or are not using today's tax-preferred options for funding retiree medical and Long Term Care (LTC).

Description: This article was written to increase the knowledge and insights of both the direct writer and reinsurer in optimizing the reinsurance negotiation process. It should help the reinsurer offer a more competitive quote and hence win a share in a reinsurance pool while simultaneously helping the direct writer obtain lower reinsurance costs helping their product pricing and bottom line.

Description: This article was written to increase the knowledge and insights of both the direct writer and reinsurer in optimizing the reinsurance negotiation process. It should help the reinsurer offer a more competitive quote and hence win a share in a reinsurance pool while simultaneously helping the direct writer obtain lower reinsurance costs helping their product pricing and bottom line.

Description: As technology continues to advance and consumers' preferences constantly change, the need for insurance to be sold at more competitive prices has become apparent, forcing the Broker channel to adjust its business model and also creating a new opportunity for the Direct-to-Consumer channel. The presenter will examine how various channels have co-existed in the past, and evaluate how they will evolve and co-exist in the future. The discussion will also include an analysis of a channel strategy to optimize results for the growth of a company. Presenters will include representative from the following distribution channels

Description: Enabling better care, mood management and even slowing and reversing memory loss for Alzheimer's and dementia care.

Description: Traditional predictive tools are not built to deal with the variability the world currently faces. The COVID-19 pandemic amounts to a prolonged black swan event, for which one must look past conventional assessments to arrive at any level of confident predictions. Behavioral analysis factors for biases and heuristics designed specifically for uncertain evolutionary contexts, and which are the primary drivers of market participants’ decisions at present. Through understanding the most likely behaviors of individuals, it becomes possible to arrive at an aggregate understanding of market outcomes.