Log in / My SOA

Medical Cost Management Strategies in Asia Pacific Health Insurance Markets

Background and Purpose

Medical cost inflation remains one of the most significant challenges facing healthcare consumers, health insurers, employers, and policymakers across Asia-Pacific (APAC) markets. Projected medical trend rates for 2026 are expected to remain elevated, continuing a multi-year pattern of double-digit increases across the region. Rising healthcare costs are being driven by several factors, including increased utilization of healthcare services, a higher prevalence of chronic diseases, adoption of new medical technologies, pharmaceutical innovation, provider pricing and reimbursement pressures, and broader health system inefficiencies. These increases continue to outpace general inflation and wage growth, placing growing pressure on insurers, employer-sponsored health plans, and healthcare financing systems.

In response, governments and insurers have introduced a range of medical cost management measures aimed at improving affordability and sustainability. These include provider payment reforms, provider network management, utilization controls, managed care arrangements, and data-driven fraud, waste, and abuse monitoring. Despite the increasing adoption of these measures, evidence on their long-term impact remains limited, particularly across markets with different healthcare financing structures, regulatory environments, and levels of system maturity.

Actuaries play a central role in managing the financial sustainability of healthcare systems through the development of medical trend assumptions, pricing health insurance products, assessing reserve adequacy, and designing sustainable benefit structures. However, actuarial decision-making often relies heavily on historical claims data and experience studies, with limited evidence available on the long-term impact of specific medical cost management interventions. This research aims to support actuaries, insurers, employers, and policymakers by providing a more structured understanding of the effectiveness, limitations, and practical implications of different medical cost management strategies across Asian markets.

Research Objective

The SOA Research Institute invites proposals for a practice application research report on the range and evaluation medical cost management strategies across selected Asia Pacific markets, with a primary focus on Mainland China and Malaysia, while additional Asia Pacific markets may be included where relevant for comparative analysis. The research report should examine how differences in healthcare financing systems, regulatory structures, and market conditions influence the implementation and outcomes of medical cost management initiatives.

The primary objective of the research report is to develop a framework of the range and effectiveness of cost management strategies that can help actuaries, insurers, employers, and policymakers assess, implement, and monitor strategies for the future. The report should support stakeholders in evaluating the impact and practical implications of different approaches, understanding implementation trade-offs, and assessing the long-term sustainability of healthcare financing, employer-led initiatives, and insurance arrangements under continued medical cost inflation pressures.

The research should address some, though not necessarily all, of the following areas:

  • Key drivers of medical cost inflation across selected Asian markets, including differences in healthcare financing structures, regulatory environments, and market maturity.
  • The range of government-led healthcare financing reforms and cost management initiatives in slowing healthcare cost growth and improving system sustainability.
  • The range, effectiveness, and impact of insurance industry, private corporate sector, and employer-led strategies in managing claims costs, healthcare utilization, and long-term affordability.
  • Operational, regulatory, behavioral, and market-related challenges that may affect the implementation and effectiveness of cost management measures.
  • Approaches actuaries can use to assess the long-term sustainability of medical plans under continued medical inflation pressures and emerging healthcare cost trends.

Note that the list above is not meant to be exhaustive but merely examples of proposed topics that may be researched.

Proposal Requirements

To facilitate the evaluation of proposals, the following information should be submitted:

  1. Resumes of the researcher(s), including any graduate student(s) expected to participate, indicating how their background, education and experience bear on their qualifications to undertake the research. If more than one researcher is involved, a single individual should be designated as the lead researcher and primary contact. The person submitting the proposal must be authorized to speak on behalf of all the researchers as well as for the firm or institution on whose behalf the proposal is submitted.
  2. An outline of the approach to be used (e.g. literature search, model, etc.), emphasizing issues that require special consideration. Details should be given regarding the techniques to be used, collateral material to be consulted, and possible limitations of the analysis.
  3. A description of the expected deliverables and any supporting data, tools or other resources.
  4. Cost estimates for the research, including computer time, salaries, report preparation, material costs, etc. Such estimates can be in the form of hourly rates, but in such cases, time estimates should also be included. Any guarantees as to total cost should be given and will be considered in the evaluation of the proposal. While cost will be a factor in the evaluation of the proposal, it will not necessarily be the decisive factor. As a guide for developing the project budget, please review the Historical Project Cost Guide (see Appendix).
  5. A schedule for completion of the research, identifying key dates or time frames for research completion and report submissions. The SOA Research Institute is interested in completing this project in a timely manner. Suggestions in the proposal for ensuring timely delivery, such as fee adjustments, are encouraged.
  6. Other related factors that give evidence of a proposer's capabilities to perform in a superior fashion should be detailed.

Selection Process

The SOA Research Institute will appoint a Project Oversight Group (POG) to oversee the project. The POG is responsible for recommending the proposal to be funded. Input from other knowledgeable individuals also may be sought, but the POG will make the final recommendation, subject to Society of Actuaries Research Institute (SOA) leadership approval. An SOA staff research actuary will provide staff actuarial support.

Questions

Any questions regarding this RFP should be directed to Research-HCCT@soa.org.

Notification of Intent to submit Proposal

If you intend to submit a proposal, please email written notification by July 24, 2026 to Research-HCCT@soa.org.

Submission of Proposal

Please email your proposal to Research-HCCT@soa.org; proposals must be received no later than August 10, 2026. It is anticipated that all proposers will be informed of the status of their proposal by the end of August 2026.

Conditions

The selection of a proposal is conditioned upon and not considered final until a Letter of Agreement is executed by both the Society of Actuaries Research Institute and the researcher.

The Society of Actuaries Research Institute reserves the right to not award a contract for this research. Reasons for not awarding a contract could include, but are not limited to, a lack of acceptable proposals or a finding that insufficient funds are available. The Society of Actuaries Research Institute also reserves the right to redirect the project as is deemed advisable.

The Society of Actuaries Research Institute plans to hold the copyright to the research and to publish the results with appropriate credit given to the researcher(s).

The Society of Actuaries Research Institute may choose to seek public exposure or media attention for the research. By submitting a proposal, you agree to cooperate with the [Society of Actuaries/sponsoring entity] in publicizing or promoting the research and responding to media requests.

The Society of Actuaries may also choose to market and promote the research to members, candidates and other interested parties. You agree to perform promotional communication requested by the Society of Actuaries Research Institute which may include, but is not limited to, leading a webcast on the research, presenting the research at an SOA meeting, and/or writing an article on the research for an SOA newsletter.

Conflict of Interest

You agree to disclose any of your material business, financial and organizational interests and affiliations which are or may be construed to be reasonably related to the interest, activities and programs of the Society of Actuaries Research Institute.

Appendix

The cost ranges below are intended as a guide for budgeting project costs for proposals in response to SOA Research Institute Request for Proposals (RFP). Please note these figures span the 33rd to 66th percentiles for all projects as well as projects that involve a specific approach (lit review, survey, etc.). They are based on historical costs over several recent years. Expected costs for some RFPs may fall outside these ranges depending on the nature of the work and resources required for completion.

All Contracted Projects

This category includes all contracted projects that the Institute has undertaken within the last several years.

The 33rd-66th percentile project costs range is $25,000 - $50,000.