Dave Dillon, FSA, MAAA, interviews Greg Sgrosso, FSA, MAAA, about his February 2017 Health Watch article, “Reasons to Reconcile.” Financial reconciliation is critical to a successful Medicare Advantage (MA) bid, and this podcast emphasizes the reasons to reconcile early and often.

Direct download: SOA_101_Dillon_Sgrosso.mp3
Category:Health -- posted at: 10:27am CDT

This podcast discusses some promising early results for self funded plans indicating that trusted services, helping people navigate the health care system can help lower health care cost trend.   Hear how having someone you trust guiding you to get the right services in the right setting can be a wonderful approach to eliminating waste in the system.

Direct download: SOA_120_Dillon_Cymerys.mp3
Category:Health -- posted at: 7:34am CDT

What do (and should) we know about public health, and why should we care? A brief discussion of the influence of public health on our lives and our work.

Direct download: Dillon_McAleer_SOA_119.mp3
Category:Health -- posted at: 8:32am CDT

In the commercial major medical health market, the significant difference between older and younger individuals becomes more important as our population gets older overall and as medical advances allow for longer lives (at a cost).  The Affordable Care Act implemented strict demographic rating restrictions on the individual and small group markets, but recent efforts have sought to relax these requirements.  What should insurers be ready to face in these already-challenging markets?

Direct download: SOA_117_Norris.mp3
Category:Health -- posted at: 8:34am CDT

Genomic testing can help inform decision making in treatment pathways for selected disorders. This podcast introduces relevant considerations around the funding of these tests that can support a greater appreciation of the risks and gains to payers for embarking on the personalized medicine journey.

Direct download: SOA_114Serre.mp3
Category:Health -- posted at: 8:11am CDT

John Culkin and Joe Slater discuss how changes in the handling of pre-existing conditions and increasing the age rating slopes could lead to remarkedly lower premiums in the Individual ACA market.

Direct download: SOA_113Slater_Culkin.mp3
Category:Health -- posted at: 12:56pm CDT

A few months ago President Trump discontinued CSR reimbursements. Join us as we explore what this means for the individual health insurance market and why it may be better to leave them in the past.

Direct download: SOA_105Ratzlaff.mp3
Category:Health -- posted at: 8:41am CDT

Find out how actuaries can contribute a unique perspective to driving better collaboration between payers and providers in an integrated delivery system towards a more financially sustainable future for both.

Direct download: SOA_106.mp3
Category:Health -- posted at: 12:05pm CDT

Dave Dillon, FSA, MAAA interviews Karena Weikel, ASA, MAAA on her February 2018 Health watch article:  Risk Adjustment:  The Details and Why They Matter.  The discussion covers the CMS-HCC part C risk adjustment model and the intricacies within.  As the health care industry moves towards value-base care, many of the arrangements have some form of a diagnosis-based risk adjustment program.  As actuaries, we understand all the intricacies and complexities built into risk adjustment programs.  We can help educate our providers, demonstrate our knowledge and provide analytic support.

Direct download: 44566978_02-01-2018_08.32.57_Dillon_Weikel.mp3
Category:Health -- posted at: 7:35am CDT

Dave Dillon and Trey Swacker discuss the potential impacts health care reform may have on the small employer market.