A universal actuarial model to improve health and lower costs

A universal actuarial model to improve health and lower costs

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Speaker(s): Ken Beckman (Central States Indemnity)

This presentation will discuss an actuarial model that offers direct financial incentives to health care providers who help reduce the prevalence of chronic disease. In contrast to most current health care financing systems that offer no monetary rewards for improved patient health, this model gives providers significant motivation to assist patients eliminate chronic conditions. Actually reversing chronic disease has not been a focus of efforts to reduce health care costs because of the common belief that once someone is diagnosed with such a condition, it will persist for life. However, this model relies on a simple, low-cost and safe approach that has demonstrated reversal of chronic conditions such as heart disease, diabetes, obesity, hypertension, and rheumatoid arthritis, without the use of medications and surgical procedures. A large body of peer-reviewed scientific, clinical, and historical evidence has shown that treatment using whole food plant-based nutrition is highly effective in reducing both chronic disease and health care costs. But as there has been little support from payers, the approach has not been widely used by health care providers. This actuarial model uses clinical and cost data to determine the objective measures of patient health (e.g. HbA1c, body mass index, etc.) that correlate with health spending to develop provider financial incentives based on improvement in these measures. It will be shown how payers in various countries with different financing systems can all use this model to improve sustainability by making it financially attractive for providers to offer the treatment that achieves optimal health. The presenter will also share results of his ongoing research studying the practical implementation issues and measuring the financial impact for an insurance company that provides education to its insureds about this treatment option.

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