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Patient Care Innovations and Their Impact on Health Insurance

Background and Purpose

In recent years, healthcare has seen rapid changes in many areas leading to better patient care and lower morbidity rates of certain conditions. Some examples of patient care innovations include the rise of telemedicine, increased health data and diagnosis from wearables, the use of virtual reality for surgery preparation, and AI interpreting radiology exams.

As the healthcare industry continues to modernize and innovate around patient care, it is important for health insurance companies to understand how the changes will impact their products.

This project seeks to explore the impact of innovations in patient care on the healthcare and health insurance industries. The research should describe one or more patient care innovations from recent years and address the key questions listed below.

  • How has the change impacted patient care?
  • How widely adopted is the change across the healthcare industry?
  • How could the patient care innovation impact the health insurance industry?
  • What further data or analysis is needed for the health insurance industry to quantify the impact?

Research Objective

The Actuarial Innovation & Technology Steering Committee (AITSC) is seeking researchers to produce a report highlighting one or more patient care innovations in the healthcare industry during recent years and their potential impacts on the health insurance industry.

Ideally, the research team should be multi-disciplinary including healthcare professionals and actuaries. Research proposals should not be limited to the examples provided in the opening paragraph, could be addressing a narrow subset of the items listed here or a wider approach.

The committee review of proposals could lead to approval or decline of the proposal. It could also suggest complementary respondents to this RFP to team up to produce a more robust proposal. Thus, the committee encourages partial response to this RFP.

The report should include a description and examples of each innovation and how the innovation has impacted patient care. Further discussion around how the patient care innovation could impact the health insurance industry and what further research or analysis is needed to quantify the impact on health insurance products should also be included.

Research proposals need not be limited to the examples provided in the opening paragraphs. They could address a narrow subset of the items listed here or a wider approach. As the review of proposals may lead to complementary respondents to this RFP teaming up to produce a more robust proposal, the AITSC encourages partial responses to this RFP.

Proposal Requirements

To facilitate the evaluation of proposals, the following information should be submitted:

  1. Resumes of the researcher(s), including any graduate student(s) expected to participate, indicating how their background, education and experience bear on their qualifications to undertake the research. If more than one researcher is involved, a single individual should be designated as the lead researcher and primary contact. The person submitting the proposal must be authorized to speak on behalf of all the researchers as well as for the firm or institution on whose behalf the proposal is submitted.
  2. An outline of the approach to be used (e.g. literature search, model, etc.), emphasizing issues that require special consideration. Details should be given regarding the techniques to be used, collateral material to be consulted, and possible limitations of the analysis.
  3. A description of the expected deliverables and any supporting data, tools or other resources.
  4. Cost estimates for the research, including computer time, salaries, report preparation, material costs, etc. Such estimates can be in the form of hourly rates, but in such cases, time estimates should also be included. Any guarantees as to total cost should be given and will be considered in the evaluation of the proposal. While cost will be a factor in the evaluation of the proposal, it will not necessarily be the decisive factor.
  5. A schedule for completion of the research, identifying key dates or time frames for research completion and report submissions. The AITSC is interested in completing this project in a timely manner. Suggestions in the proposal for ensuring timely delivery, such as fee adjustments, are encouraged.
  6. Other related factors that give evidence of a proposer's capabilities to perform in a superior fashion should be detailed.

Selection Process

The AITSC will appoint a Project Oversight Group (POG) to oversee the project. The AITSC is responsible for recommending the proposal to be funded. Input from other knowledgeable individuals also may be sought, but the AITSC will make the final recommendation, subject to Society of Actuaries (SOA) Research Institute leadership approval. An SOA Research Institute staff actuary will provide staff actuarial support.

Questions

Any questions regarding this RFP should be directed to David Schraub, Senior Research Practice Actuary, at dschraub@soa.org or +1-847-706-3560.

Notification of Intent to Submit Proposal

If you intend to submit a proposal, please email written notification by November 4, 2022, to Korrel Crawford at kcrawford@soa.org.

Submission of Proposal

Please email your proposal to Korrel Crawford at kcrawford@soa.org; proposals must be received no later than November 18, 2022. It is anticipated that all proposers will be informed of the status of their proposal by the end December 2022.

Conditions

The selection of a proposal is conditioned upon and not considered final until a Letter of Agreement is executed by both the SOA Research Institute and the researcher.

The SOA Research Institute / AITSC reserves the right to not award a contract for this research. Reasons for not awarding a contract could include, but are not limited to, a lack of acceptable proposals or a finding that insufficient funds are available. The SOA Research Institute / AITSC also reserves the right to redirect the project as is deemed advisable.

The SOA Research Institute / AITSC plans to hold the copyright to the research and to publish the results with appropriate credit given to the researcher(s).

The SOA Research Institute / AITSC may choose to seek public exposure or media attention for the research. By submitting a proposal, you agree to cooperate with the SOA Research Institute / AITSC in publicizing or promoting the research and responding to media requests.

The SOA Research Institute / AITSC may also choose to market and promote the research to members, candidates and other interested parties. You agree to perform promotional communication requested by the SOA Research Institute / AITSC, which may include, but is not limited to, leading a webcast on the research, presenting the research at an SOA meeting, and/or writing an article on the research for an SOA newsletter.

Conflict of Interest

You agree to disclose any of your material business, financial and organizational interests and affiliations which are or may be construed to be reasonably related to the interest, activities and programs of the SOA Research Institute / AITSC.