Description: Healthcare cost is increasing at 9.3% in Asia in 2017 and health insurance cost will eventually catch up, making healthcare unaffordable to aging populations. Inefficiency in healthcare system is a contributing factor. In this session, use cases on how AI is impacting the health insurance operations on 3 core challenges. Document processing: A lot of documents are generated in the healthcare ecosystem, medical reports, diagnosis, invoices etc. Currently most of the documents are still reviewed manually and rely heavily on users’ judgement. Customer engagement: Customers are generally under distress and feel rejected during the claim process. It is due to the time and process needed to get the information they look for, the gap between the sales and claims process, and the reimbursement amount. Claim settlements: Claim adjudication is a technical process that review the disease, treatment and policy coverage. The process is specific to disease and difficult to be generalized. Thus, the process is far from consistent and invites fraud, abuse and wastage in this area.

Description: The speech briefly analyzed the national reimbursement list from the perspective of health economics. The overall principle and logic behind it, and the relevant important considerations; In the construction and practical use of the national reimbursement list, it discussed the commercial insurance directory importance and enlightenment of national reimbursement list to establishment of commercial insurance directory.

Description: This panel discussion focuses on long term disability insurance examining the market, overinsurance problem, and new product designs.

Description: Tomorrow’s risk landscape is shaped by macro trends and their interconnections, and those new, changing but not-yet envisioned risks will shape tomorrow's insurance needs. Karen would like to share Swiss Re's insights on new emerging risk themes and trends, climate change and its effects on the L&H business. Hopefully the session can provoke new ideas and enable us to build resilience together.

Description: This session is about managed-care provider networks: organizing networks, information needs, monitoring utilization and risk/reward methodologies. From Record of Society of Actuaries Vol. 19, No. 1A.

Description: Companies with the intention of being the top, trusted source(s) in an information overloaded world.

Description: Panel discussion focused on the Effective Use of Capital. Topics included: 1. Definition of capital 2. Appropriate level of capital and surplus in a life insurance company 3. Alternatives for deploying capital 4. Returns a life company should demand on invested capital 5. How much a company should charge for lending its capital in reinsurance transactions

Description: Shared savings deals are all the rage these days. Significant numbers of payers and provider groups in many markets around the U.S. want to engage in shared savings contracts covering commercial, Medicare and Medicaid patients. The fundamental question underlying a value-based contract is, for whom is the value accruing? Ostensibly, value is accruing to the sponsor—whether employer or public payer—but should be accruing to the provider as well. Often design flaws in value-based arrangements and contracts and/or the inability to execute in a value-based paradigm diminish the savings that could have accrued, create inequities in value or drive unintended consequences. This presentation will provide attendees with insights into how to design a workable value-based payment initiative, how to educate both payer and provider participants, and how to oversee the initiative’s operations. Specific topics will include: • Attribution logic: prospective, retrospective and the details in between • Risk adjustment: why one model doesn’t fit all arrangements, and even if it does, how do you implement? • Data and reporting: matching business needs to the payer’s willingness to be transparent and provider capabilities • Quality improvement as a component of payment: actionable and tied to the attributed population or just “out there?”

Description: This session from the 1984 SOA Salt Lake City Meeting covers the special problems and opportunities of managing a small life insurance company including distribution systems, the role and expertise of the reinsurer and the role that a consultant can play in developing the business direction.