mjamilkowski

6 ms·

1.
by mjamilkowski 5y ago
There are a lot of opportunities to partner with other innovators / startups. We are always looking for ways to do things differently. For you, it translates into a different experience with greater access and more convenience. It
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by mjamilkowski 5y ago
Oh yeah it can get crazy expensive. I was just asking to gauge your sense of risk aversion. One of the things I think is missing is being able to bring value to you even if you do not have claims. Kind of like how we have responded to o
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by mjamilkowski 5y ago
And for those of you willing to stick it out and help make change happen here, we are hopeful that our differentiated product, use of technology, and processes will stir dialog and stimulate change. There is a saying "eat the mammoth
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by mjamilkowski 5y ago
Now I am curious why you buy health insurance. Are you insuring against the risk of a high cost claim, like a heart attack or premature baby, cancer or transplant? Is it just something you think you should have (but from your comments, do
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by mjamilkowski 5y ago
Sounds like each one of those "integrated" components are actually separate things and each has an expense to you. And theres noone at the plan to help you navigate or coordinate what you access or why you should. All up to you.
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by mjamilkowski 5y ago
Hi Mark here - Just to be clear we are not using ROI, but rather clinical impact. The expectation being that the expense of encouraging better care through facilitating coordination, clinical teaming, and incentives addresses issues of acce
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by mjamilkowski 5y ago
Hi - Mark here - I'm curious to know what you get for your $500 monthly premium. Do you get anything else of value, any incentive programs, knowledge support, coaching, etc. I am assuming you get free access to telehealth. I would li
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by mjamilkowski 5y ago
I have a different take. Haven was an attempt to get 3 large, very different, groups to reach consensus on some very contentious issues. It was akin to asking everyone at the Thanksgiving dinner table to agree on a political issue. Were
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by mjamilkowski 5y ago
Yes it would be possible - and I know of a couple of benefits consultants that have tried to do this, but bias and independence is a vexing issue. Keep the ideas coming!
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by mjamilkowski 5y ago
Underwriting a whole group actually gives us protection from risk selection and creates a more population based risk which is more stable. Yes there will be individuals that have extreme expenses, which is why we have reinsurance. It is t
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by mjamilkowski 5y ago
We are embedding several programs into the benefit plan and still charging a lower price. We think its the best solution to the employer demanding positive ROI on the disease management and telehealth based solutions
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by mjamilkowski 5y ago
Hi – Mark (Chief Actuary) here. Now we’re talking.... rolls up sleeves ...thanks for asking the fun question. Medicare for All (MFA) is a proposal to provide the Medicare-based basic basket of medical services as a baseline for health c
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by mjamilkowski 5y ago
Product: It is possible that in the future we would roll out a PPO based product to have a broader out of network option. Right now we do not have any plans to do so. Our target employer groups are focused geographically which fits nicel
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by mjamilkowski 5y ago
Yes you are right - And we recognize this as part of our outreach and contract development efforts. Our collaboration seems to be working and we are getting great reaction from physicians. We believe in a simple approach to keep it unders
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by mjamilkowski 5y ago
I’m sorry to hear about the bad reaction you had to the vaccine and then the terrible experience you had with the care system. You are correct, individuals do need to have better understanding and connection to the cost of care, and the co
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by mjamilkowski 5y ago
For B2B, it’s worth noting that most Americans still receive their health coverage through employers, and this is especially true for the 200-2,000 company size segment. Meeting the majority of people where they are seems to be a reasonably
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by mjamilkowski 5y ago
Thanks for the great summary!
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by mjamilkowski 5y ago
thallium205 does a great job of summarizing some of the common approaches insurers have used to try and get outcomes to be part of the payment of care delivery. We find that most physicians have not been asked what they consider to be crit
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by mjamilkowski 5y ago
There are several studies and analysis about waste in the US healthcare system. This one gives a great overview and summarizes several other studies as well. https://pubmed.ncbi.nlm.nih.gov/31589283/ The waste usually