Description: This session is about the details of the inception and implementation of the Oregon Health Plan. From Record of Society of Actuaries Vol. 18, No. 1B.

Description: This session addressed the following regarding benefit plan design to control claim costs: What has been tried? What works? and What else can be tried?

Description: For a long time the primary focus of private LTC insurance companies has been to educate the public about the need for private LTC insurance and to make the product more acceptable to a wider population. To this end there have been numerous changes to the product design to make this product more acceptable to general population. However, one of the things that may have been overlooked in those product design changes is the need for alignment of policyholder and insurance company’s interests, which is to make coverage more affordable and to reduce adverse selection. Incentivizing good behavior from policyholders can not only make LTC insurance policies less expensive but also help policyholders make better health choices, which can help them stay healthy for a longer time. These incentives may also reduce some of the inherent risks in a long term care policy and may help in increasing the sales of private LTC insurance.

Description: SOA Product Development Section Contest Winning Article. Contest was to provide a creative article on future technology for the life insurance industry.

Description: The medical scheme approach adopted by several African countries has failed to meet the needs of those in informal employment and rural communities. This is partly due to affordability amongst these individuals as well as a lack of awareness of how healthcare financing products work. Community based healthcare organisations have achieved greater levels of success in this regard by carefully incorporating the peculiarities of communities in benefit design and involving community members in the management of these healthcare solutions. There are lessons to be garnered from the countries where these have been implemented with some level of success. Even as countries aim towards universal health coverage, observing the unique needs of different communities within a country is essential to ensure resources are utilised efficiently and that healthcare needs are targeted effectively.

Description: An actuarial model that provides financial incentives to providers to offer patients an approach that can reverse chronic disease and reduce health care costs

Description: This article describes the results of three years of work by Blue Shield of California to collaborate with hospitals and physician organizations to reduce cost and improve quality for commercial populations in targeted geographies.