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IAAHS Webinar: Closing the Financial Gap in Colombia’s Health Sector: A new methodology for calculating the UPC

Join us in our upcoming webinar on 

 

April 20, 2022
11:00 pm (New York) / 8:30 am (New Delhi) 
12:00 noon (Tokyo)  / 1:00 pm (Sydney)
Session length: 1h 30 minutes
 
 

ABSTRACT
 

Colombia has a publicly funded health insurance program that aims to have universal coverage known as Sistema General de Seguridad en Social en Salud (SGSSS) that is regulated by the law 100 of 1993 (Lonono and Frenk, (1997)).  The Colombian population benefits from a fundamental right to health enshrined in the Colombian constitution which, according to the constitutional court of Colombia (statutory law 1751 of 2015), entitles the enrollees to be provided with health services and technologies on a comprehensive basis.  Coverage is provided via insurers (EPSs) with reimbursement from the Colombian government according to an age/sex/geographic risk adjustment system (described in Duncan (2018)).  As with many countries, this entitlement to coverage causes budgetary problems.  The Colombian Health Ministry (Ministerio de Salud) retained Santa Barbara Actuaries Inc. to develop a new condition-based risk adjustment system with the intent of controlling spending and more equitably distributing revenue based on member need.  In this presentation, we discuss our modeling process and the resulting risk adjustment system.
 
 
 

SPEAKERS

Ian Duncan Ph.D. FSA FIA FCIA FCA CSPA MAAA

Adjunct Professor, Dept. of Statistics & Applied Probability, University of California Santa Barbara. B.Phil (Balliol College, Oxford) Ph.D. (Heriot-Watt University, Edinburgh) Health Actuary (40 years)/Consulting Actuary (30 years) Author, "Healthcare Risk Adjustment and Predictive Modeling" (2nd ed.) (Actex Publications) and "Managing and Evaluating Healthcare Intervention Programs" (2nd ed.) (Actex Publications) President, Santa Barbara Actuaries Inc. and Nvoyance LLC.

Juan Diego Mejia - MS

Ph.D. candidate in the Dept. of Statistics & Applied Probability at the University of California Santa Barbara and an intern at Santa Barbara Actuaries Inc. Masters degree from National University, Colombia.
 

Register now!