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 approach to quantify medical intervention savings when medical claims data is not available by leveraging overlapping measurement techniques.

Description: Presenters discuss the differences between patient treatment protocols and length-of-stay guidelines, and some of the issues that payers confronted as the protocols were implemented. From the Record of the Society of Actuaries, Vol. 24, No. 2.

Description: In this session, participants learn the issues large employers face with respect to increased health care costs, the goals and objectives of the value-based purchasing initiative and similar initiatives and the different methods used to implement these initiatives. The Leapfrog Group, a hospital performance initiative, and Bridges to Excellence, a physician performance initiative, are specifically discussed. From the Record of the Society of Actuaries, Volume 30, No. 1, Session 31

Description: Read the June 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: This article talks about the new onsite clinic at Hewitt and how it benefits employees and employers.

Description: Our panelists discuss mechanisms to measure affordability, reducing costs through product design and other responses by plans, employers & providers. From the Record of the Society of Actuaries, Volume 29, No. 3, Session 82

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