Description: This article examines the history, theory, and effectiveness of high-deductible health plans and health savings accounts.

Description: Essay stating accessibility, affordability and efficiency are the key to success in the future of healthcare.

Description: An update on HMO market trends and reinsurance products, and services supporting them.

Description: The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. The presenters will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. They will also provide concepts to help manage the coming wave of gene and cell therapies.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: Mental health spending has reached $147 billion in the United States with demand only increasing greatly impacting society as nearly 1 in 5 experience these issues. There are even more indirect costs associated with mental health causing a national crisis surpassing 1 percent of the GDP. These costs coupled with the severe lack of licensed clinicians calls for an innovative solution. Through years of development and completion of a randomized controlled trial, Prevail has built and validated a low-cost, scalable solution. Prevail's clinically proven digital mental health treatment provides increased access to care while reducing overall health costs. Private and public payors should being reimbursing this model and offering it to their members.

Description: Discussion of direct primary care and how it helps with several challenges in health care today. DPC improves care coordination, improves outcomes, improves doctor and patient satisfaction, and reduces spending. DPC successes promote the view that primary care should not be covered by insurance; rather, it should be paid for directly.

Description: New research shows that we often make sub-optimal choices, when selecting a health insurance plan, that lead to unnecessary out-of-pocket expenditu

Description: This paper describes in detail each of five options available to small Texas employers wanting to purchase insurance for their employees. It then describes the advantages and disadvantages to the various players: carriers, employers, employees, and agents. It points out that each player will act in its own interest.