Universal Health Consultants

‘Risk Sharing Models for Private Healthcare Insurance’ was presented to the International Actuarial Association Health Section Colloquium in Cape Town on 14th May 2007.

Synopsis

The risk sharing models used by private healthcare insurers and their medical service providers are diverse and have resulted in a range of economic and patient outcomes across the healthcare value chain. They can involve the insurers and their suppliers, key stakeholders and medical service providers. They sometimes seek to mitigate downside risks and improve the likelihood of achieving benefits from the upside potential, leading to market development opportunities. The paper discusses the patient’s role, responsibilities and capability to make informed choices about their healthcare treatment options, as the patient’s behaviour can influence the likely outcomes. In some countries (e.g. UK), the rights of private healthcare insurance beneficiaries have been recognised in the regulatory concept of TCF (Treating Customers Fairly). ERM (Enterprise Risk Management) concepts and techniques can be used by private healthcare insurers and medical service providers, in conjunction with their suppliers and key stakeholders. A holistic view will be proposed, aligned with recent developments in ERM thinking and its applicability to the private healthcare arena.

IAA Health Section Colloquium

13th – 16th May 2007

CTICC

www.iaahs2007.com

To contact us for more information:

E-mail: uhcg@cwgsy.net