Description: Direct Primary Care (DPC) is a newer model of primary care delivery in which patients or employers pay for care directly on a membership basis; insurance and other third-party payment is not used. Early studies show significantly improved patient health outcomes and lower expenditures for DPC patients compared with similar patients receiving traditionally delivered primary care. Additional research is needed to better understand physician perspectives about the model and the role of patient selection in early results.In this session we discuss research projects that may shed light on the DPC model and on whether early results indicate more about the model or about the patients who use it.We discuss an SoA research project that interviews DPC physicians to better understand their views about the model and its early results. We also discuss a paper that analyzes characteristics of patients who receive primary care from a DPC physician and compares them to characteristics of patients who receive primary care in more traditional ways. This cross-sectional study surveys all adult patients of a convenience sample of several DPC practices. Variables include demographics, socio-economic status (SES), type of additional coverage (if any), whether DPC fees are paid by an employer, and self-reported health status. The Medical Expenditure Panel Survey is the main source of comparison data. For a given cohort of demographics and additional coverage, we determine whether DPC patients have similar health status, demographics and SES as non-DPC patients. This study will provide insight into the degree of selection into DPC by observable patient characteristics.

Description: The presenters will provide updates on research being conducted under SOA sponsorship. This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes.

Description: As value-based solutions evolve, it is more important than ever for providers to understand their performance and how it is measured, along with the drivers of success. Presenters will cover the evolution of past risk-transfer programs such as Medicare Shared Savings Program and Next Generation ACO. They will also discuss the new Primary Care First and Direct Contracting models recently announced by CMS.

Description: Panelists at this session of the SOA 2001 Toronto Spring Meeting discuss incorporating reinsurance costs into the pricing of their retail products. Panelists also discuss the different effects of various reinsurance arrangements.

Description: This session discussion is about the new niches in direct response marketing such as new products, database marketing and relationship marketing. From Record of the Society of Actuaries Vol. 15, No. 2.

Description: Representatives of various health care professions will address issues such as falling hospital occupancy rates and a growing shortage of primary care physicians. The presenters will then discuss the short-term and long-term effects of these issues on the health care delivery systems on North America. From the Record of the Society of Actuaries, Vol. 21, No. 3b.

Description: Presented at April 1986 Spring Meeting. This session discussion is about participation in alternative delivery systems, direct contracting with medical providers, participation in coalitions, employer demands for data, employer selection criteria for health carriers.

Description: In an age of accelerating transformation—technological, financial, and regulatory —reinsurance continues to be an important component of capital management strategy across the insurance industry. This is true in spite of, and sometimes because of, the evolving ecosystems of ceding companies and reinsurers. Direct writers and reinsurance carriers are coping with a number of critical challenges that are undermining growth potential and threatening profitability. Waning demand and increased capacity for traditional products have, in some instances, led companies to struggle to achieve traditional profit targets. An increase in commoditized pricing, internal expenses related to increased regulation, inefficiencies in internal infrastructure, and the sustained low interest rate environment are additional factors impacting the top and bottom lines of reinsurers and primary carriers alike. In this session we will explore these critical challenges and highlight prevailing practices that organizations are using to deal with the changing landscape.

Description: 1993 SOA Annual Meeting in New York. This session is about core benefit plans from a state and from a national level. Core benefit plan is used interchangeably in this session with standard benefit plan, basic benefit plan, and minimum benefit plan. Topics included: 1. A summary of the legislative process. 2. A summary of options available within the national health-care debate, with a primary focus on the Clinton proposal. 3. The role of core benefit-plans in health-care reform.

Description: This session discussion is about marketed health products, distribution methods, and experience. Discussion includes direct response, return of premium, accident, hospital indemnity, hospital income, medicare supplement, nursing home indemnity, long-term care and AIDS. From Record of the Society of Actuaries 1987 Vol. 13, No. 1.