The goal of the initiative goingforward is to assess new technologies, innovations, and analyticsfor managed care in order to find ways to address the burden ofhigh health care costs. (Photo: Shutterstock)

A new collaboration on rising health care costs is bringing actuaries to thehealth reform discussion. Initiative 18/11, named to reflect thepercentage of GDP the U.S. spends on healthcare compared to the rest of the developed world, is a jointproject of the Society of Actuaries (SOA) and the Kaiser FamilyFoundation (KFF).

The two groups recently released a report, “Initiative 18/11: What Can We DoAbout the Cost of Health Care?” The report outlines some of thechallenges the U.S. continues to struggle with, despite reformssuch as the Affordable Care Act (ACA).

“While the U.S. pays more for health care, it falls short onmany important quality measures, such as life expectancy, which is78.8 years in the U.S. compared with 82.0 years in comparablecountries. In addition, a 2017 Commonwealth Fund study ranked theUnited States last in overall quality of care compared with 10similar countries,” the report said.

Related: High prices still the cause of ridiculous healthcare spending

The SOA describes itself “the world's largest provider ofactuarial research and education,” and KFF is one of the country'sbest-known health care policy and research groups.

The initiative was launched in March, 2018, with a conferencethat brought together more than 30 health care experts thatincluded actuaries, health economists, employee benefits experts,and hospital administrators.

The new report is a result of that effort, and it finds thatInitiative 18/11 will look closely at two key drivers of healthcare cost: the price of health care goods and services and chronic disease. The goal going forward is toassess new technologies, innovations, and analytics for managedcare in order to find ways to address the burden of high healthcare costs.

The report said the group's planning committee has identifiedthree main deliverables:

1) A research project analyzing the 5 percent of the populationthat accounts for 50 percent of the health care costs, with anemphasis on understanding the population, increasing earlyinterventions, and reducing overall costs

2) A strategic initiative documenting the pharmacy developmentand pricing process, with the goal of improving transparency

3) A strategic initiative examining the impact new technologiesand care models may have on cost and quality, with the goal ofbetter understanding the current environment and identifyingpotential risks and opportunities

The group also talked about a concept called Managed Care 3.0,which they describe as a transformational model of health delivery.“This concept is still loosely defined at this point, but we canexpect to see considerable evolution in both care models andadministrative functions in the next few years as new technologies,data sources and analytical methods emerge,” the report said. “Thechanges will not be limited to technology alone. We can expect tosee increased innovation in techniques to prevent diseases,identify gaps in care earlier, and coordinate needed care.”

The initiative said it will now launch a Phase 2 of itscollaboration, and that will include the three deliverables listedabove, along with some focus on issues such as specific chronicillnesses and consumer behavior.

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