Description: This article details the medical stop-loss coverages purchased by HMOs, small insurers and providers taking delegated financial risk in payor agreements. Along the way we will identify strategies purchasers often use to save money on medical stop-loss.

Description: A preview of the contents of the latest issue, including essays & interviews related to health care reform, provider reimbursements, rate filing review, and medical errors.

Description: Adding value in the development, production and marketing process of medical devises regulatory environment, designer/manufacturer perspective, product failure and litigation risk. Issue No. 44.

Description: Discussion of how actuarial input is needed to ensure fair regulations with regards to Genetic Testing. Issue No. 45.

Description: The impact of Medicare on retiree medical. Issue No. 44.

Description: Two years ago, before COVID-19 changed everything about how we provide and receive health care, telehealth was largely provided by third-party vendors to treat a narrow range of acute one-and-done conditions. The value proposition was simple: a fast and easy member experience would drive satisfaction and engagement; high member satisfaction and engagement would drive health plan savings and member retention. Clearly, from the perspective of utilization, telehealth—as a viable alternative to in-person care during a pandemic—worked. And with COVID-19’s nudge—or was that a push?—toward cultural acceptance, the health care system is in a better position to capitalize on telehealth’s original promise of expanded access, lower cost and better outcomes than it was two years ago. But in the wake of the pandemic, it is just as clear to us that if telehealth is to live up to its full potential, some changes are needed. The rest of this article presents five ideas for improving the delivery of telehealth going forward.

Description: The impact of Medicare payments on retiree medical. Issue No. 46.

Description: This article focuses on mandatory supplemental benefits offered by general enrollment plans and Dual Eligible Special Needs Plans (D-SNPs) Medicare Advantage plans from 2017 to 2021.

Description: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: Terrorism risk and catastrophe reinsurance. From Health Section News, August 2003, Issue No. 46.