Global Health Briefs

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A man in a medical bed chats with an attending physician
Global Health Brief: Understanding medically necessary (medical necessity)
By
  • Colin Weston
Articles May 2023

 

The goals of patients, medical care providers, and payers (e.g., insurers, governments) should align to provide the most effective processes to diagnose and treat a patient’s health conditions. When cost enters the equation, however, friction can develop. <...
A man in a medical bed chats with an attending physician
Articles May 2023
Global Health Brief: Understanding medically necessary (medical necessity)

 

The goals of patients, medical care providers, and payers (e.g., insurers, governments) should align to provide the most effective processes to diagnose and treat a patient’s health conditions. When cost enters the equation, however, friction can develop. <... Read More
Image of labwork
Articles March 2023
Global Health Brief: Experimental Treatments – Current Considerations

Many health insurers exclude experimental treatments without clearly defining which treatments they would consider experimental. In this Global Health Brief, RGA's Colin Weston discusses the need for clear definitions in policy language. He also explores how drugs, t...

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Blood testing
Articles December 2022
Global Health Brief - Platelet Rich Plasma: A Closer Look

In this Global Health Brief, RGA Middle East's Dr. Avinash Samudre provides a comprehensive overview of platelet-rich plasma (PRP), also known (albeit less commonly) as autologous conditioned plasma (ACP), platelet-rich growth factors (GFs), platelet-rich fibrin (PRF...

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Articles March 2022
Global Health Brief: COVID-19 2022 – Current Treatments, Health Claims Impacts

As the world enters year three of the COVID-19 pandemic, mortality and morbidity has changed substantially and for the better since the virus’s early days. Successful options for treatment have also been increasing, but at this point they are still few in number. RGA...

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Articles October 2021
Global Health Brief: Update Robotic Surgery

Robotic surgery (also known as robot-assisted surgery) is one of the fastest-growing specialties in surgical medicine today. In the past two decades, it has seen a steep rise in utilization, and today it is integral to several medical specialties. Ultimately, success...

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Chemotherapy of patients
Articles June 2021
Global Health Brief: Prognostic Genomics and Breast Cancer
Up to 70% of breast cancer patients prescribed chemotherapy after their surgeries might not need it. But how can clinicians make that decision, and insurers determine whether to cover the determining tests?  Read More
Allergies with dandelion in the wind
Articles November 2019
Global Health Brief – Navigating Allergen-Specific Immunotherapy (AIT)

Allergen-specific immunotherapies (AITs), which offer relief for some classes of allergies, are increasingly becoming a preferred treatment option. However, these treatments can be challenging to review and assess from the insurance perspective. This brief offers hel...

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Genetics collage in a lab
Research and White Papers April 2019
Genetics and Insurance: Challenges and Opportunities II
The impact of genetic testing on the insurance industry will continue to be an important topic of actuarial research for some time as insurers address its effect on pricing and valuation. Insurance product development opportunities may also emerge to capitalize upon the... Read More
Fetal ultrasound
Articles March 2019
Global Health Brief: Fetal Testing
For more than half a century, ultrasound and Doppler have been the two main technologies used to administer screening and diagnostic tests during pregnancy. Explore these technologies with Dr. Elizabeth Gil Agular in Global Health Briefs. 

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Lab worker extracting stem cells from storage
Articles September 2018
Global Health Brief: Stem Cell Therapy
Stem cell therapies are becoming increasingly visible and supported in clinical medicine. The U.S. and Canada currently have well-defined stem cell business models and are making significant investments in the field. Japan has also seen new regulations governing regener... Read More
Articles February 2018
Global Health Brief – Liquid Biopsy
Liquid biopsies are noninvasive tests that could potentially lead to early detection of cancer by identifying the genetic material cancerous tumors shed into the bloodstream and other bodily fluids. It is now possible to test  for biomarkers such as circulating tum... Read More
Fetal ultrasound
Articles July 2017
Global Health Brief – Fetal Medicine: New Frontiers
This article discusses advances in fetal medicine and whether specialized fetal cover might help contain the often catastrophic costs of congenital claims for both parents and insurers.  Read More
Articles February 2017
International Health Brief - Bariatric Surgery
As bariatric surgery advances and becomes more common, it is increasingly being used as a quick-fix treatment for weight-related conditions. This article explores the type of patients who may benefit from bariatric surgery, provides an update on the various surgical tec... Read More
Articles June 2016
International Health Briefs - Radiosurgery
Claims professionals can benefit from a greater understanding of the role and efficacy of radiosurgery, particularly when used for conditions with complex neurological causes and in cases that might formerly have been deemed untreatable.

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Articles April 2016
International Health Briefs - Genetic Information
Genomic tests and their outcomes are creating important considerations for insurers – especially in underwriting and claims. Read More
Articles January 2016
International Health Briefs - Preexisting Condition Exclusions Around the World and Application Language
The pre-existing condition (PEC) exclusion clause, long a staple of health insurance underwriting, has undergone a measure of change; this brief reviews PEC language and governance. 


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Articles November 2015
International Health Briefs - Robotic Surgery
For the past several years, a host of procedures have become the province of robot surgical assistance. This article examines the history, current state and claims considerations of robotic surgery. 

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Articles July 2015
International Health Briefs - Advances in Hepatitis C Treatment
This brief explains hepatitis C, discusses the new drugs and their efficacy, and provides guidance around verification of medical necessity of treatment, claims considerations and underwriting considerations. Read More
Articles October 2014
International Health Briefs - Introduction to Cancer Treatment
The treatment of cancer is undergoing a major period of research and development; this article explores the insurance implications. Read More
Articles November 2013
Global Claims Views - International Health and Questioning Medical Necessity
The definition of what is medically necessary varies considerably, with the weakest wordings only requiring that treatment be ordered by the patient’s treating physician. Explore best practices with RGA. 

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