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This webinar is the first of a two-part series which examines the different types of risk provider organizations may face and different ways to mitigate its impact. The first session in the series focuses on building a base of understanding, effectively demystifying the world of risk and explaining various ways to address it. The second session takes a deeper dive into provider excess coverage and how to make it work specifically for your organization.
Part 1 will cover
- Types of risk-taking organizations and risk-sharing contracts
- Current trends
- Provider risk concerns and solutions
- Carve-outs and coverage options
Part 2 will cover
- Understanding third-party provider excess (PXS) product
- How to determine an appropriate deductible
- Coinsurance, annual max, incurred, and paid: what they mean and why they matter
- Customization options and lasers
- Unique considerations for ACO Reach
Speakers:
Rick Lassow, FSA, MAAA, is vice president of underwriting and actuarial at Summit Reinsurance Services, Inc. His background in risk adjustment and health reform has provided the basis for deep dives into complex issues, including challenges and opportunities associated with cell and gene therapies. Rick recently spoke on cell and gene therapies at the 2023 Society of Actuaries Health conference and at AMCP 2023, hosted by the Academy of Managed Care Pharmacy. Rick is a subject matter expert in cell and gene therapy topics that include Approaches for Estimating Costs and Cases, Evaluating and Pricing for the Risk, and Understanding When and How Reinsurance Makes Sense.
Scott Machut, CPA, FLMI, is vice president, sales for reinsurance and provider excess at Summit Reinsurance Services, Inc. With extensive experience in reinsurance, insurance, and management consulting for some of the world’s largest companies, he brings a unique perspective to client partnerships. Scott has focused on the life and health lines of business throughout his career and leads initiatives in business development, risk management, and cost containment