Description: Panelists discuss current issues and trends impacting health plan contracting with providers. Hospital and physician contracting is discussed from both a payer's and provider's persepctive. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 30

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 discussion is about state-mandated health benefits. Who should decide and who should pay? The basis of making decisions, effect on insurance rates, impact on self-insurance, legislative process and timing of savings. From Record of Society of Actuaries Vol. 16, No. 1.

Description: At this presentation, the panelists address the following questions: 1. How is health insurance risk measured? 2. How and why do surplus requirements differ between health insurance and life insurance? 3. How and why do surplus requirements differ among health insurers [e.g., Commercial, Blue Cross, HMO] and among health insurance products? 3. What are some of the current techniques being used by health insurers for determining target or required surplus and for managing surplus? 4. How do the rating agencies view surplus requirements for health insurers? From the Record of the Society of Actuaries Vol. 17, No. 3A.

Description: This session will address the increased cases of managed care in Medicaid states. This will include some indication of how utilization patterns differ for those populations versus commercial populations. From the Record of the Society of Actuaries, Vol. 21, No. 3b.

Description: The Health Section Research Team is pleased to make available the following research study and Excel model that provide a framework for estimating the financial impact of health plan provider network risk. The research was conducted by the Denver office of Milliman, Inc. The Excel workbook allows the user to assess cost implications of aspects of network risk under various assumptions. The assumptions in the workbook can be altered by the user and be applied to test a range of scenarios.

Description: Attendees gain exposure to various approaches for effective surplus management for health entities. From the Record of the Society of Actuaries, Volume 28, No. 2, Session 91

Description: The Health Section Research Team is pleased to make available the following research study and Excel model that provide a framework for estimating the financial impact of health plan provider network risk. The research was conducted by the Denver office of Milliman, Inc. The Excel workbook allows the user to assess cost implications of aspects of network risk under various assumptions. The assumptions in the workbook can be altered by the user and be applied to test a range of scenarios.

Description: This session discussion is about under 25 life group medical reform, model bills, state variations, congressional proposal, community rate implications, effect of RBRVS on provider fees and plan cost. From Record of Society of Actuaries Vol. 17, No. 4A.