Description: This article discusses Accountable Care Organizations, how they work, managing risks and their expectations to bend the cost curve.

Description: Recognizing the importance of fortifying risk adjustment programs against selection based on nontraditional variables, the Society of Actuaries’ Health Section sponsored an in-depth study into the relationship of nontraditional variables with health costs. This report presents the results of this study.

Description: To identify and quantify the U.S. healthcare insurance disruptors within a five-year horizon.

Description: Beginning with the 2019 Benefit Year, CMS (the Centers for Medicare and Medicaid Services) has provided guidance that allows Medicare Advantage Plan Sponsors much greater flexibility in tailoring benefits to promote clinical, care management, and financial goals. The guidance allows for a broader menu of supplemental benefits and also enables plans to target benefit enhancements to beneficiaries afflicted with specific disease states. This session explores the ramifications of the policy changes on Plan Sponsors and beneficiaries, and discusses the different ways that Plan Sponsors are taking advantage of the additional flexibility.

Description: Telehealth enables the delivery of health care services to patients that are not in the same location as providers. Over the past decade, telehealth has been used increasingly to complement face-to-face patient encounters, and is particularly important to addressing health care needs in rural areas. Recent regulatory catalysts, particularly in the Medicare Advantage program, have served to elevate the visibility and importance of telehealth in the overall health care delivery system. Starting in 2020, Medicare Advantage plans can offer any clinically appropriate physician services through telehealth as part of the standard Medicare benefit. Network adequacy standards can also be met via telehealth providers under certain programs. This presentation will cover the basics of what constitutes telehealth, and provide tangible demonstrations of telehealth technology (simulating variations mediums through which services are delivered). We will cover the what, the why, and the where (anywhere) of telehealth in 2020.

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

Description: This report evaluates alternative payment models that potentially could be instituted by healthcare payers and manufacturers.

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: This abstract describes a presentation that reviews the latest AHCA update and its impact on market stability from short-term and long-term points of view.

Description: This is the databook for the "Health Care Cost - From Birth to Death". This study used commercial data held by the Health Care Cost Institute (HCCI) and Medicare fee-for-service data to analyze health care cost differences by age and their contribution to overall health care cost change. The commercial data includes claims from 2002 through 2010 and the Medicare data includes claims from 2006 through 2010.