Description: Many drugs, like the immunologic drugs used to treat inflammatory and oncologic conditions, are FDA-authorized to treat more than one condition. Given different conditions have varying clinical outcomes and costs, it is likely the same drug provides a range of value across multiple conditions. However, such drugs have traditionally had a single list price and corresponding payer net cost. Indication-based pricing and benefit design (IBPBD) is intended to address the variable clinical and economic value for the same drug across multiple treatment indications. As this trend continues to evolve, the determination of drug value by treatment indication will create risks and/or opportunities in pharmacy benefit design, ultimately impacting pharmacy PMPM forecasting and incurred costs. Learn from faculty as they: Provide the business context for IBPBD. Describe varying structural approaches. Discuss the market conditions that can motivate or demotivate payers. Explore operational barriers. Recommend a role for actuaries. To bring the discussion to life, a case study will be reviewed. By attending the session, you will be able to: • Describe the meaning of Indication-Based Drug Pricing and Benefit Design (IDPBD). • Understand the risks and opportunities with IBPBD. • Articulate the advantages and disadvantages of distinguishing the value of a drug by treatment indications.

Description: As our industry rapidly adopts more advanced technologies, today's actuaries have more data and greater analytical capabilities than ever before. Nevertheless, these advancements come with their own set of challenges.Come explore the tools and techniques to optimize your processes and avoid common pitfalls so that you can get the most out of your experience studies.

Description: "Most patients enter the health care system through their primary care provider or through the Emergency Room or an Urgent Care Center. How an emergency room is structured, managed, and provides care is one of the major forces impacting the total cost of care. Yet it is often an after-thought and ignored by both health plans and health systems. In reality, the structured introduction of efficient practices can substantially reduce the quantity and cost of health care services. Further explore useful information to better understand and see how there are still substantial opportunities for improvement."

Description: There is increasing industry interest in applying behavioral science to optimize product design decisions and improve outcomes for both insurers and their customers. With a growing set of options within product designs, predicting consumer behavior continues to get increasingly complex. Join this webcast for an overview of key behavioral economic concepts. Key insights will be shared from two SOA projects that explore how behavioral economic techniques can be used in various parts of the life insurance new business process and enforce management.

Description: Come discuss how reinsurers can work side by side with insurer to better develop products, and lift in the areas that reinsurers have more experience, help matching products with distributions (or vice versa) and provide advanced technologies associated with tools and software. The speakers will also present Direct to Consumer plan from various points of view, i.e., distributors, carriers, and reinsurers. Some case studies will also be presented where traditional reinsurers and asset-intensive reinsurers helped insurers bring products to life.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.