105 - Reinsurance Considerations for Providers Participating in Value Based Contracts105 - Reinsurance Considerations for Providers Participating in Value Based Contracts With ... and payers. Stop-loss insurance; Accountable care organizations= ACO; Catastrophic risk; Health reinsurance; ...
Description: With the frequency of healthcare providers engaging in risk growing, the consideration and valuation of reinsurance in these value based contracts is becoming increasingly important. This session will explore reinsurance topics from the perspective of providers including: - A briefing on the products needed in the market and the products currently offered in the market,- Valuation of reinsurance terms offered through the value based contract versus options available on the open-market,- Administrative issues, and- Aggregate and specific stop loss considerations,This session will review the actuarial considerations in addition to the practical business considerations for all parties involved in value based risk contracts including providers, reinsurers, and payers.Hide
- Authors: Annie Man, Jeremiah Reuter
- Date: Jul 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Payment models; Reinsurance>Stop-loss insurance
ACO Shared Savings – Can today’s friction turn into collaborationyears now in an attempt to reduce the total cost of care. Often neither party has a complete view of the ... that work better for both parties. Accountable Care Organization = ACO Risk Adjustment Value Based Insurance ...
Description: ACOs and payers have been engaged in shared savings agreements for several years now in an attempt to reduce the total cost of care. Often neither party has a complete view of the data with providers missing pharmacy data, and payers are often missing historic data on a provider group’s members when they were previously covered by other payers. Inconsistent data and black box predictive models have created friction that has become amplified given the continual increase in ACO membership and the dollars at stake. Learn how payers and providers are working through these challenges to find solutions that work better for both parties.Hide
- Authors: Jeremiah Reuter, , James Dolstad
- Date: Sep 2019
- Competency: Results-Oriented Solutions; Strategic Insight and Integration
- Topics: Experience Studies & Data; Financial Reporting & Accounting; Health & Disability