Description: 1994 SOA Meeting, San Antonio. This session on physician reimbursements focused on arrangements that might be offered by managed care companies, such as HMOs. It included an overview of key definitions, concepts, and incentive compensation arrangements.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: This session is about purchasing group health, distinctions between health alliances and health insurance purchasing cooperatives, and role in administration's proposal. It also covers proposed health care reform. From Record of Society of Actuaries Vol. 19, No. 4A.

Description: Presented at April 1986 Spring Meeting. Addresses costs, cost measurement and control, how target cost levels are established, and the cost/benefit perceptions of employers.

Description: Panelists discuss HMO open access plans [in-network-only coverage, but no referral requirements] and the provider contracts and administrative systems that are needed to support them in a cost-effective way. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: Experts discuss new strategies related to provider contracting and network management. Topics include various reimbursement approaches and risk-sharing arrangements, unique risk arrangements for certain provider specialties, unique risk managements for specific diseases, and the role of care management/care coordinators. From the 2002 Record of Society of Actuaries, Volume 28, No. 2. Session 59PD of the San Francisco Spring Meeting.

Description: This session will teach the ABCs of HMOs and PHOs. Topics include provider networks, contracting, utilization controls, integrated health care, From Record of Society of Actuaries Vol. 20, No. 3A.

Description: Panelists at this session of the SOA 1989 Chicago Spring Meeting discuss Health Maintenance Organizaions [HMOs] including their hisotry, the marketplace, physician structures and relationships with HMOs, cost control issues and the future of HMOs.

Description: This session from the 1995 SOA Boston Meeting presents the results of risk adjuster research in health care assessment and discusses the potential use of risk adjusters in health care reform efforts. From the Record of the Society of Actuaries, Vol. 21, No. 4b.

Description: Panelists provide their perspectives on current issues in the dental market, such as: · Product development · Experience trends · Competitive marketplace · Future outlook From the Record of the Society of Actuaries, Volume 27, No. 1, Session 65