Virtual Health Summit: Broadening the Focus

In this session, the Academy’s Health Equity Committee chairperson Becky Sheppard and member Ugo Okpewho will provide an introduction to the Broadening the Focus framework. Together they’ll share how the Committee took on the project, which is rooted in the limitations of traditional ROI, inconsistent evaluation practices, and the need for more holistic decision-making. Through multi-disciplinary interviews with researchers, clinicians, evaluators, economists, and actuaries, the Committee developed the framework to form the basis of a conversation that can lead to a more transparent, equitable, and complete program evaluation. Sheppard and Okpewho will walk attendees through the framework, including the guiding principles, the multi-dimensional domains (framing, stakeholders, benefits, costs, measurement), and the Committee’s next steps in promoting and supporting the project.

Speakers

• Becky Sheppard, MAAA, FSA, Chairperson, Health Equity Committee, American Academy of Actuaries
• Ugo Okpewho, MAAA, FSA, Member, Health Equity Committee, American Academy of Actuaries

Learning Objectives

After attending this session, participants will be able to:

1. Explain the rationale for developing the framework, including limitations of relying solely on financial ROI and the need to include indirect costs, indirect savings, and non-financial outcomes.

2. Describe the methods used to create the framework, including interviews with subject matter experts and synthesis of themes related to outcomes, engagement, strategic metrics, and communication challenges.

3. Identify the five core domains of the framework (framing, stakeholders, benefits, costs, and measurement) and the types of questions and considerations within each.

4. Recognize how the framework complements existing evaluation methods by supporting multi-year thinking, mitigating bias, clarifying assumptions, and enabling alignment across disciplines.

Attendees will gain:

• A clear roadmap for applying the framework in their own evaluation work, including how to articulate goals, identify stakeholders, assess benefits and costs, and evaluate evidence.

• Examples of how to broaden evaluation inputs to include clinical outcomes, preventive care indicators, engagement metrics, equity considerations, productivity, and long-term impacts.

• Tools to improve communication across disciplines, including strategies to reduce inconsistent language, explain uncertainty, and tailor evaluation results to stakeholder priorities.

Have questions? Our speakers will stay online during this break for questions and engagement.

A panel of subject matter experts will apply the framework to behavioral health programs. Case study presentations will feature diverse perspectives from economists, clinicians, researchers, regulators, consumer advocates, and actuaries.

This case study will feature examples such as integrated behavioral health programs, substance use disorder interventions, and equity-focused evaluation models. The discussion will illustrate how health outcomes, engagement, long-term effects, and indirect impacts can be incorporated alongside ROI when assessing program value. An interactive program, the case study will encourage direct and active engagement from the audience with the panelists.

Moderated by Becky Sheppard, MAAA, FSA, Chairperson, Health Equity Committee, American Academy of Actuaries

Speakers

• Mila Kofman, Executive Director, DC Health Benefit Exchange Authority
• Deborah Steinberg, Senior Health Policy Attorney, Legal Action Center
• Dr. Rachele Hendricks-Sturrup, Research Director of Real-World Evidence, Duke-Margolis Institute for Health Policy
• Tatyana Kotlovskiy, MAAA, ASA, Optum Health

Learning Objectives

After attending this session, participants will be able to:

1. Apply a principles‑based framework to behavioral health program evaluation, considering clinical, equity, economic, and operational dimensions.

2. Interpret case studies demonstrating indirect effects, long‑term outcomes, and subgroup-level impact.

3. Recognize communication challenges between actuaries and non-actuaries, including the need for shared vocabulary and cross-disciplinary framing.

Attendees will gain:

• A structured approach for evaluating behavioral health programs under real-world constraints, including data limitations and multi-year impacts.

• Templates for framing evaluation questions, identifying stakeholders, and documenting assumptions transparently.

• Examples of behavioral health evaluation metrics such as reductions in ER visits, hospitalizations, preventive care uptake, and quality-of-life measures.

A panel of subject matter experts will apply the framework to food and nutrition interventions. Case study presentations will feature diverse perspectives from economists, clinicians, payers/sponsors, and actuaries.

This session will apply the Broadening the Focus framework to Food Is Medicine (FIM) programs such as medically tailored meals, produce prescriptions, and nutrition support interventions. Speakers will examine how different metrics—clinical outcomes, reductions in acute utilization, patient experience, equity impacts, and cost‑effectiveness—contribute to understanding program value beyond ROI. Panelists will also discuss why FIM programs are often held to higher evidence standards than other interventions, an issue rooted in asymmetric ROI expectations and systemic power dynamics. An interactive program, the case study will encourage direct and active engagement from the audience with the panelists.

Speakers

• Sara Teppema, MAAA, FSA, Vice Chairperson, Health Equity Committee, American Academy of Actuaries
• Kofi D. Essel, MD, MPH, FAAP, Food as Medicine Program Director, Elevance Health
• Julian Xie, Director of Medicaid and Benefits Integration, Share Our Strength
• Laura Makaroff, DO, Senior Vice President of Prevention and Early Detection, American Cancer Society

Learning Objectives

After attending this session, participants will be able to:

1. Apply the principles-based framework to FIM interventions, assessing direct and indirect benefits across multiple stakeholder groups.

2. Evaluate FIM programs using alternative metrics including clinical improvements, engagement, access, equity, and long-term outcomes.

3. Explain challenges such as the “wrong pocket problem,” churn, and multi-year horizons when modeling nutrition interventions.

4. Compare FIM evaluation approaches to evaluation of other benefits such as pharmaceuticals, noting differences in evidence expectations and organizational incentives.

Attendees will gain:

• Examples of realistic evaluation designs for FIM programs, including outcome selection, timing, and measurement limitations.

• Approaches to quantify economic and social value—such as productivity, satisfaction, and community trust—alongside financial ROI.

• Insights into how actuaries can support cross-sector evaluation and communicate results clearly to program sponsors, clinicians, and policymakers.