Description: Part 1 of a 2-part series exploring implementation issues for the Mental Health Parity and Addiction Equity Act of 2008 MHPAEA. Part 2 addresses the new enforcement safe harbor, how the regulations could impact the business of behavioral health care and the impending decisions for payors, employers, providers, and insureds.

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: Article describes enhanced primary care models and provides citations on whether or not health care savings have been achieved.

Description: This discussion looks at the causes of the increase of costs in medical care and what can be done to keep these costs under control. Form Transactions of Society of Actuaries 1959, Vol. 11, No. 30 AB.

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

Description: This panel discussion session examines the meaning and implication of holistic health. From the 1979 Record of SOA, Vol. 5 No. 3

Description: This session discussion is about who is the health care manager, how is health care management evaluated, ethical considerations, malpractice liability and data systems support. Inlcudes a discussion on gatekeepers, provider contracting, utilization management, benefit design, DRG creep, long-term care, From Record of the Society of Actuaries 1987 Vol. 13, No. 1.

Description: This session is about rationing health care. From Record of Society of Actuaries Vol. 18, No. 4A.

Description: This session discussion is about hospital strategies in delivering and financing care, physician reaction to current market, physician strategies in delivering and financing care, and provider reaction to managed care programs. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.