Evolution of Health Insurance: Including Application of Lessons Learned from Healthcare to P&C Lines of Business

Join Ryan Cichy from KPMG for a lively conversation on the evolution of health insurance and discuss recent lessons learned from healthcare, and how they can be applied to Property and Casualty lines of business – including workers’ compensation, auto insurance, and structured settlement insurance.

Discussion topics within this session will include:

• Aspirations of healthcare’s triple-aim – lower costs, better care, and improved health – and how misaligned incentives can impact financial and health outcomes.

• The evolution of healthcare payment models – from Fee For Service to Value Based Care – and how this shift is re-shaping traditional insurance operating models.

• Re-thinking workers compensation/auto-insurance medical claim exposure through the use of healthcare “tools” – including targeted provider networks, Social Determinants of Health (SDOH) data, and a re-focus of Utilization Management efforts on quality.

• The usage of new data sources (structured/unstructured) to enhance reserving through predictive analytics – building on claims-based reserving approaches.

About the Presenter:

Ryan Cichy is a Senior Associate in KPMG LLP’s Health Actuarial practice in the Radnor, PA office with over ten years of experience in the health insurance industry. He frequently serves as an Actuarial Subject Matter Professional for health insurance companies in support of actuarial analysis, strategic financial and operational risk assessments, and process optimization reviews. His clients include a wide-array of stakeholders across the insurance industry – including commercial issuers, state governmental entities, and the Federal government.

  • Date:Monday, September 13
  • Time:9:15 AM - 10:05 AM EDT
  • Session Type:Concurrent Lite
  • Session Code:CL-1
  • Learning Objective 1:Describe the Triple Aim and how aligning incentives can help to further improve flexibility of actuarial pricing and reserving
  • Learning Objective 2:Explain how traditional health insurance operating models are shifting from fee-for-service to value-based care and the impact on actuaries
  • Learning Objective 3:Recite potential opportunities to utilize healthcare “tools” in Property & Casualty lines of business
  • Learning Objective 4:Identify potential new data sources (structured/unstructured) to apply to predictive analytics – building on claims-based reserving approaches
  • Level of Knowledge:Level 1: No prior knowledge of the subject
  • Moderator:Sara Hemmingson
Ryan Cichy