Read the latest Inspire article in the Biosimilar series from Greg Warren!.

Healthcare Disruptors: A critical change that is occurring right now in today’s health care system, and frankly, one that is improving it, is the introduction of new entrances to the system itself.

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Healthcare Disruptors: Emerging changes provide a new path to improve the system, although opening new avenues to the system that need careful management and oversight.

So how are payers thinking through Medicare bids? Actuaries know bids for 2024 coverage are due soon. As of now, there is only Humira and Amjevita approved on the market. Read more about how timing matters! #humira #pharmacy #pbm.

In today’s market the question often comes up, “when is the right time to go self-funded?”, actuaries can help you know that answer and help you be set up for success. Read more »».

"By working with an actuary, you can design benefit plans that meet the unique needs of your organization, while also keeping costs under control.". Read more »».

"When it comes to fully insured groups, it’s important to have a complete understanding of your employee benefit plans.". Read more »».

Whether you’re a self-funded group looking to manage your employee benefits more effectively or a fully insured group exploring the possibility of self-funding, there are practical reasons to seek out the service of an actuary. Read more »».

3 Reasons Self-Funded Groups Should Consult an Actuary:. 1. Assessing Risk.2. Plan Design.3. Fiscal Planning. Read more in the AHP Inspire blog »».

3 Reasons Fully Insured Groups Should Consult an Actuary:. 1. Renewal Analysis.2. Cost Management.3. Claims Analysis. Read more on the AHP Inspire blog:.

In addition to avoiding regulatory interference, health insurers can use the RBC benchmark to understand their potential risk exposure. Read more about health insurer capital in the latest Inspire article »»

“Hospitals saw margins they were retaining through 340(b) in some ways disappear as they were being rerouted to contract pharmacies.” – Tony Pistilli, Consulting Actuary. Find out more on the SOA podcast! #340b #Pharmacy . Listen to episode:

"Providers can overcome many of the barriers to VBC, particularly lack of resources and unpredictability of revenue streams, by consolidating with other groups and benefiting from economies of scale.". Read more on the Inspire blog!

"Fair targets reward high-performing groups for lowering the cost of care relative to a reasonably achievable goal, which accounts for the group’s attributed population and operating environment." Read the latest on the Inspire blog!.

Some big news today over on the AHP website!

A significant change observed since the pandemic began is the portion of companies choosing to self-fund their benefits. According to the Kaiser Family Foundation 2020 Employer Health Benefit Survey, 67% of covered workers are in a self-funded plan.

For much of the past, larger companies have self-funded their health benefit plans, but more recently we are seeing an increased number of the smaller companies being open to taking on these insurance risks as well.

Reductions in inpatient care can be achieved through effective implementation of evidence-based clinical decision-making and are often related to alternative venues of care where quality outcomes and patient satisfaction have been observed. Find out more:

An effective manner to lower total health care costs is not accomplished by lowering utilization across all categories. Significant savings can be achieved by emphasizing managed care and office visits over facility claims. Read more!

A few ways actuaries are relied upon during due diligence by insurance companies are:. • Actuarial Appraisals .• Reserves and Reinsurance.• Regulation.• Interest Rates. Read more!.