In the 5 Points of Health Care™ series of roundtables, we invite subject matter experts to discuss best practices around innovating successfully in their sector.
Actuaries offer a unique perspective on the “inner workings” of a health insurance company. Join Shelley Webb, Provider Reimbursement Actuary, Regence, and Karin Swenson-Moore, Pricing Actuary, Regence, for a round table discussion on connecting the dots between provider reimbursement, new innovative products and services, and health insurance premiums
Shelley Webb currently leads the commercial Provider Reimbursement Analytics actuarial department for Regence Blue Cross Blue Shield spanning provider contracting analysis, provider risk arrangements (Total Cost of Care, ACOS, bundled payments) and provider business intelligence tools. Prior to her current role, Shelley led the analytics behind the Treatment Cost Estimator for HealthSparq, a consumer transparency company. She is currently collaborating with the Cambia product team and an Echo Health Venture company on developing innovative product ideas that will lower costs, increase quality, and improve the consumer experience. She is passionate about the industry and the opportunities for change. Prior to joining Regence, Shelley worked as an actuarial consultant for Reden & Anders in San Francisco, CA. She has been with Regence in Seattle, WA, for 12 years.
Karin Swenson-Moore joined Cambia Health Solutions in January 2008 and is Director, Actuarial focused on commercial group pricing. In her current role, she provides leadership of actuarial pricing activities for commercial group and stop loss lines of business for Regence and member plans in Idaho, Oregon, Utah and Washington. Key responsibilities for her teams include commercial rating strategy, regulatory rate filing development, rates, factors and rating formula development and maintenance, new product pricing, pharmacy strategy, self-funded business strategy, stop loss financial analysis, and group rating engine maintenance.
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