The Disruption of the Health Plan Market


Edward Cymerys, FSA, MAAA

During the webcast “How Silicon Valley Startups are Disrupting the Health Plan Market Webcast,” March 17, Edward Cymerys, FSA, MAAA, and a panel of startup founders in Silicon Valley will explore how new companies in the San Francisco Bay area are bringing big changes to the health industry. The startup panelists include Sean Duffy, CEO and co-founder of Omada Health; Ali Diab, CEO and co-founder of Collective Health, and Ash Damle, CEO and founder of Lumiata.

“The health industry has been somewhat immune to the disruption that many other industries have seen with new technology,” explains Cymerys. “We’re going to try and give participants a little insight as to why things are different in Silicon Valley, and what is it that has enabled these startups to accomplish what they have accomplished, and to grow and bring a different capability to the market.”

These new capabilities are certain to bring some disruption to the health market plan. “It is inevitable that when major technology changes hit, the industry has to either dramatically transform, or new metrics will come out on the scene and replace the companies that we see on the market today,” notes Cymerys.

Cymerys experienced the changes these companies bring to the health market plan first hand. He was senior vice president and chief actuary at Blue Shield of California for almost a decade and has more than 20 years of experience in the California marketplace with a focus on finance, actuarial pricing and underwriting.

“When I was introduced to Lumiata my reaction was ‘why didn’t I meet you when I was at my old job?’” he recalls. “Risk adjustment had just burst on the scene and was becoming a more important part of the business. We had to be able to demonstrate that our members didn’t have gaps in care and quality and we were struggling with how to measure quality.”

With his actuarial background and experience, Cymerys had a unique role in the new order of things. “I started working with some of these companies in an advisory role and soon realized that I was getting excited about the changes that these startups had the potential to bring,” he said. “Actuaries can help these companies understand and focus on how these capabilities they’re bringing to market can best be used in the insurance environment and have an impact in the cost and quality of services for members.”

During the webcast, Cymerys and the panelists will explore how to drive innovation, how the right partnerships can make companies more competitive and the importance of fostering a culture that promotes breakthroughs.

Sign up for the webcast.

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