July 17, 2013

The Intersection of Health Insurance and Health Care: Evaluating the Move From Health System to Health Insurer

Overview

The federally mandated health insurance exchanges and continually evolving accountable care delivery models are creating opportunities for health systems in the commercial and government insurance markets.

Drinker Biddle partners Matthew P. Amodeo and Daniel W. Krane teamed with Milliman Management Consultant Keith Kieffer and Milliman Consulting Actuary John Meerschaert to provide valuable insights and practical guidance to health systems evaluating their options in the health insurance space. The panelists discussed legal, insurance and actuarial issues impacting co-branded network arrangements, shared savings/loss arrangements and health system-sponsored insurance products and joint ventures.

Additional topics covered include:

  • The importance of conducting an internal gap analyses to assess system readiness to assume insurance risk.
  • The critical role of actuaries in evaluating the terms of proposed risk sharing/assumption arrangements with insurance carriers.
  • Key legal issues involved with co-branded network arrangements and contracts.
  • The business of insurance issues confronted by health systems looking to assume risk.

 

The Intersection of Health Insurance and Health Care from Drinker Biddle & Reath LLP on Vimeo.

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