Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: This article discusses techniques used to create risk scores to help determine appropriate primary care panel sizes for a provider organization.

Description: Article describes enhanced primary care models and provides citations on whether or not health care savings have been achieved.

Description: This article is directed to the payors—especially self-funded employers and TPAs—that seek to improve the health of the populations they cover in addition to administering the plan. Greater use of primary care is one way to better manage the health delivery. The results should also impact costs in a measurable way. Issue No. 59

Description: Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Direct-to-provider contracting is a strategy in which a self-insured entity negotiates a contract directly with a provider of healthcare services rather than through a third-party administrator (TPA), often with the goal of driving value-based care. This article discusses the considerations for employers and providers with direct-to-provider contracting.

Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: Third in a series giving an overview of direct marketing.

Description: Essay of using microeconomics and Embedded Value concepts to evaluate direct marketing programs.

Description: This article is a recap of the 2004 Insurance Direct Marketing Forum. From News Direct, January 2005, Issue No. 49.

Description: This article evaluates findings from a new LIMRA focus group consumer study that examined the decision-making process that consumers follow when buying life insurance including their use of direct channels, including direct mail, the internet and call centers.