Description: The cell and gene therapy marketplace is quickly evolving and continues to grow as a risk concern for governments, health plans, stop loss insurers and reinsurers. In this webinar, we discuss currently approved tissue, cell and gene therapies, the near-term pipeline, uptake considerations, case management processes, plan document and contract considerations, risk mitigation processes and programs, and network considerations.

Description: CMS has pioneered innovative strategies for Medicare and Medicaid to address Social Determinants of Health (SDOH). Employers can learn from these models to implement similar approaches for their employee populations. Learn how employers can understand and address SDOH, the incentives for doing so, and the broader benefits.

Description: Learn how insurers provide new opportunities for efficiency and value creation from product design and underwriting through customer engagement and claims. Glimpse some industry use cases for Gen AI and its outcomes as observed by the first movers.

Description: This article is an update on the No Surprises Act, which is a U.S. Act aimed to reduce the risk that a person unexpectedly receives out of network charges for their health care visits. This is Part 2; Part 1 was featured in Health Watch's Sept 2024 issue.

Description: What are Biosimilar drugs? Are they the same as generic drugs? What potential impact might Biosimilars have in the United States prescription drug landscape and it’s economics? This article explores those questions as well as exclusivity and interchangeability.

Description: There is a big wave of changes coming to the pharmacy market. The extent is not yet fully known, but there are trends we can follow that help us predict. Biosimilar uptake is key to driving savings, but it can take a while to ramp up. Biosimilars bring competition, and this coming wave will bring unprecedented Biosimilar competition.

Description: When designing and pricing a healthcare product, it is not only important to know how to model frequency and severity, but it is essential to understand human behavior. Of course, the issue of anti-selection in medical insurance is well known as individuals know more about their health and prior expenditures than an insurer does. This type of behavior is certainly rational, and to be expected.

Description: Article reviews the data a year into the unwinding of continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates have been adjusted, and compares those results to what has been modeled with the SOA Mediciad Unwinding model.

Description: Moral issues behind paying for a transplant. Issue No. 46.

Description: This is a table from an article in The Actuary Magazine entitled A Strategic Analysis of the U.S. Life Insurance Industry Part II: Products.