Description: 1992 SOA Regional Meeting, Chicago. This discussion is about direct marketing growth in the 1980s, sustaining the growth in the 1990s, regulatory constraints in the 1990s, impact of continuing production cost increases, new product designs, and declining response rate.

Description: In today’s marketplace, consumers are driven by research, reviews and ease-of-use more than before. They want to be empowered in their buying decisions and are turning their backs on insurance agents as the source of information for their buying decisions. The direct-to-consumer (D2C) platform addresses the expectations of the modern consumer and provides an opportunity for insurers to automate and execute underwriting in real time with better results than has been seen with traditional processes—and at significantly lower costs. D2C not only helps insurers by improving processes, reducing costs and maximize sales; it can also be used to provide a range of services through an online platform to increase customer engagement. Driven by the need to remain competitive and against the threat of new entrants, insurers foresee extensive use of direct-to-consumer channels as an alternative distribution method. However, to remain competitive they must throw away their outdated thinking and become future-oriented in the acquisition of customers. This starts with understanding D2C models in the insurance industry.

Description: This session will provide information about the current landscape for employer to provider direct contracting. We will discuss the number and types of the most prevalent direct contracts and provide a forum to discuss the likely future direction of these arrangements with point of view consideration from employers, providers and payers.

Description: When compared to 10 developed countries, the US ranks last in overall health care performance, highlighted by per capita spending that is 50% greater than the next country and last place rankings in efficiency, equity, and healthy lives. Escalating costs and decreasing affordability continue to pose the primary challenge in U.S. healthcare as cost pressures are increasing for all who pay for healthcare: health plans, governments, employers, and consumers. From 2010 to 2015, the average health plan medical loss ratio increased from 86% to 90% and average employee contributions to premiums increased by 24%. This session will investigate how health plans could bend the cost curve by focusing on solutions such as medical/Rx cost reduction opportunity assessments, VBC maximization, PBM relationship maximization, care model redesign, provider/health plan collaboration, and next generation product design.

Description: The interplay between technology and design to create safe, comfortable and thriving environments for aging in place and managing care costs.

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: From a session at the annual meeting of the Society of Actuaries held in Chicago, Illinois, October 15-18, 2000 This session discusses continuing care retirement communities and other provider organizations, such as nursing facilities, assisted living facilities, and residential facilities. This panel discusses trends in the retirement housing industry and practices and opportunities for more effective management of the cost of care.

Description: Discussion of various alternatives for financing health care.: It discussed providers,the uninsured employers of uninsured workers, employers through taxes , assessment on health insurance and general revenues.

Description: This session will provide an overview of the various types of critical illness and long term care plans in the U.S. market. It will highlight key factors to consider for effective product design and risk management for these types of products.

Description: In the current value-based care marketplace, there are various reimbursement models that tie payments for care delivery to the quality of the care provided. The purpose is clear – change reimbursement to focus on value by rewarding better outcomes and lower spending. However, implementation it is complex, and many challenges emerge during this transition for both providers and payers.Providers often lack sophisticated actuarial capabilities or clear understanding of the connection between finance and clinical operations. For these reasons, they enter risk arrangements without knowing how to strategically manage and mitigate risks and fully transfer the reimbursement changes into clinical decisions. For payers, a truly viable value-based payment model that rewards the most valuable providers needs a multidisciplinary approach and a solid financial model. Such a model also requires transparency and a clear transitional road map for providers to encourage participation and collaboration. In this session, we will discuss lessons learned through case studies of working with both providers and payers on value-based care issues. We will illustrate the current state of the complex financial structures by presenting examples of value-based financial models, feasibility analyses, and strategies to design a payment model beneficial to both providers and payers. We will also explore the clinical collaboration necessary to make it all work, as well as present some best practice strategies to facilitate strong payer-provider collaboration.