Agenda Day 4

 

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Day 1 | Day 2 | Day 3 | Day 4

Wednesday, June 14
6:00 a.m. – 10:30 a.m.
6:00 a.m. – 7:15 a.m.

Session Sponsor(s): Health Section

Presenter(s): Timothy Stotlzfus Jost, J.D., Emeritus Professor, Washington and Lee University School of Law

Listen to Tim Jost, emeritus professor, Washington and Lee University School of Law, as he discusses the most recent developments in health care reform, with special focus on the areas that impact actuaries most directly.

Representatives from Health Section Council leadership will give an update on Council activities and initiatives. 

This breakfast is open to all meeting attendees at no charge. Please be sure to register in order to receive a ticket.

Session Coordinator(s) Brian Edward Pauley, FSA, MAAA

Facilitator(s)

7:30 a.m. – 9:00 a.m.

Session Sponsor(s): Health Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Francois Millard, FSA, FIA, MAAA

Presenter(s): Joseph Dieleman, Ph.D.; Francois Millard, FSA, FIA, MAAA

Experience Level: Intermediate

CPD: 1.80

Country Relevance: USA

Description:
Presentation of wellness program savings estimates from the Global Burden of Disease (GBD) US Disease Expenditure Study. The results presented in this session are a derivative study based on extensive research done by the Institute of Health Metrics and Evaluation (IHME) to estimate total US health care expenditures by disease and category of spending. This new study, which is a collaboration between IHME and wellness actuaries, uses these spending estimates and GBD Comparative Risk Assessment study to estimate the proportion of health care expenditures associated with histories of heightened risk factors.

Learning Outcomes:
At the conclusion of this session, attendees will be provided with comprehensive and robust estimates of the potential savings from effective wellness programs.

Session Coordinator(s) Howard J. Bolnick, FSA, HONFIA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Lo Linda Chow, FSA, MAAA

Presenter(s): Rowen B. Bell, FSA, MAAA; Lo Linda Chow, FSA, MAAA; Robert A. Hanes, FSA, MAAA

Experience Level: Beginner - Intermediate

CPD: 1.80

Country Relevance: USA

Description:

This session will discuss recent FASB developments on GAAP accounting for long-duration and short-duration insurance contracts, with an emphasis on health products in general, and the implications to long-duration health products such as long-term care and disability insurance in particular.

Learning Outcomes:
At the conclusion of this session, the audience will have a better understanding of the anticipated changes in GAAP reporting for long duration contracts.

Session Coordinator(s) Ashlee Mouton Borcan, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: Strategic Insight and Integration

Moderator(s): Clay Farris

Presenter(s): Davis Burge, FSA, MAAA; Sabrina H. Gibson, FSA, MAAA; Christopher John Truffer, FSA, MAAA

Experience Level: Intermediate

CPD: 1.80

Country Relevance: USA

Description:
Medicaid is currently changing and evolving as part of the repeal or the reform of ACA. Almost every week there is new information coming from Capitol Hill on potential changes to the program. This session will discuss the most recently proposed changes along with their implications for the program and for financing of the program. It will also discuss other important and timely Medicaid topics. Examples of topics that may be discussed are:

  • Potential Changes to Medicaid Funding
  • Considerations for Developing Block Grant or Per Capita Cap Funding
  • Increased State Flexibility in Medicaid - What could that mean?
  • Impact of Changes on the Mega Rule
  • Maximizing LTSS Expense Savings in State Programs
  • Integrating Community Services into Medicaid
  • Standardizing Medicaid Administration Across States to Improve Efficiencies

 

Join us for an informative and lively group discussion!

Learning Outcomes:
At the conclusion of this session, attendees will have a better understanding of current issues in the Medicaid marketplace.

Session Coordinator(s) Davis Burge, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Reinsurance Section

Competency: External Forces & Industry Knowledge

Moderator(s): Michael David Mulcahy, FSA, MAAA

Presenter(s): Jeffrey E. Babino; Richard Leavitt, ASA, MAAA; Michael David Mulcahy, FSA, MAAA

Experience Level: Intermediate

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
Panelists will be expected to present:

  1. A general overview of the disability products from a capital management perspective (such as reserves / capital / investing)
  2. How a reinsurance program designed for capital management would work and
  3. How a reinsurance program designed to take on the tail or longevity risk would work

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Evaluate their own company's appetite for a disability reinsurance program;
  • Determine what type of reinsurance program would best suit their company; and
  • Explain the capital management programs to their stake holders.

Session Coordinator(s) Michael David Mulcahy, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Presenter(s): Theresa S. Bauer, FSA, MAAA; Jeremiah D. Reuter, ASA, MAAA; Greger J. Vigen, FSA

Experience Level: All

CPD: 1.80

Country Relevance: USA

Description:
This is single workshop spanning two sessions (Sessions 114 and 129) where we will explore the Role of a Healthcare Provider Actuary which was also introduced in Session 99 (note Session 99 is not a pre-requisite for participating in this workshop although it is recommended). In this workshop we will define, explain and provide examples for the three core value based care competency domains that providers need to address as value based care takes a more pronounced role in their organizations. In addition we will link the skills that actuaries bring to bear for providers for these value based care activities as well as provide insights into the various provider roles in which actuaries need to interact to be successful in their positions. Once this foundation has been shared with the audience we will then proceed to exploring the provider actuary's role by reviewing real-world interactive audience case studies. This approach will illustrate the various roles that a provider actuary supports in his/her day to day activities.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  1. Define and educate the three value based care competency domains that providers must address to be successful in today's value based care environment.
  2. Provide a deeper understanding for the multiple value based care areas within provider organizations where actuaries can make significant contributions.
  3. Provide real world case studies that highlight the obstacles faced by providers and contributions made by provider actuaries to help the providers make a better business decision.
  4. Identify the anticipated future needs of providers based on the current trajectory of value based care activities.

This workshop has two parts; attendees must register for both - Session 114 and 129.

Session Coordinator(s) Jay Patrick Hazelrigs, ASA, MAAA

Facilitator(s)

Session Sponsor(s): Health Section

Competency: Professional Values

Moderator(s): Johann K. Leida, FSA, MAAA

Presenter(s): Johann K. Leida, FSA, MAAA; Darrell D. Knapp, FSA, MAAA; Maria M. Sarli, FSA, EA, FCA, MAAA; Thomas D. Snook, FSA, MAAA

Experience Level: All

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
Want to learn more about two of the newest ASOPs? Curious about how an ASOP is created? Than come to this lively and interactive session to hear directly from some of the people from the task force involved in the creation of new ASOPs about modeling and setting assumptions. This session will give you a great opportunity to get credit towards your professionalism CE requirement while enjoying a rare opportunity to hear directly from members of the relevant ASOP task forces.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Describe the process that goes into the creation of a new ASOP
  • Interpret the guidance provided by new ASOPs about modeling and setting assumptions
  • Apply modeling and setting assumptions ASOPs in daily work

 

Session Coordinator(s) Joe L. Wurzburger, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Gregory L. Warren FSA, MAAA, FCA

Presenter(s): Kathryn Bronstein; Michael Einodshofer; Andrew Erwin Kirchner, FSA, MAAA

Experience Level: All

CPD: 1.80

Country Relevance: USA

Description:
The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. This session will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. Presenters with different viewpoints will discuss both the financial impact of unpredictable pharmacy trends and management strategies that can mitigate this risk.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Explain the impact specialty drugs trends have had on earnings volatility
  • Explain how specialty pharmacy management strategies can be used to reduce this risk
  • Evaluate the risks and benefits associated with each strategy

 

Session Coordinator(s) Gregory L. Warren, FSA, FCA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Canadian Track

Competency: Strategic Insight and Integration

Presenter(s): Stuart D. Rachlin, FSA, MAAA; Ella Eileen Young

Experience Level: Beginner

CPD: 1.80

Country Relevance: USA and Canada

Description:
This session will compare and contrast the Canadian public (and, to a lesser extent, private) health care system in juxtaposition to US health care. Participants need not have specialized knowledge of either system. Focus of the presentation will be on cost containment strategies as balanced against effective health care services. Differentiation of strategies, such as wellness and prevention in contrast to diagnosis and treatment, will be discussed.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Describe differences between health coverage in the US and Canada,
  • Compare financial drivers of each system, and
  • Evaluate opportunities for change.

 

Session Coordinator(s) Ben Marshall, FSA, FCIA, CERA, MAAA, J.D.

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Joan C. Barrett, FSA, MAAA

Presenter(s): Joan C. Barrett, FSA, MAAA; Roy Goldman, FSA, CERA, MAAA; Brian Edward Pauley, FSA, MAAA

Experience Level: All

CPD: 1.80

Country Relevance: USA

Description:
What an exciting time to be a health actuary. In this session, presenters will discuss the major disruptors to the health insurance landscape, including its impact on the profession, the analytical challenges and the impact on stakeholders like consumers, and employers and health plans. This session is based on a recent strategic initiative chartered by the Health Section Council.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Define the major disruptors to the health care system,
  • Describe why they will be disruptors, and
  • Compare the impact on stakeholders.

 

Session Coordinator(s) Joan C. Barrett, FSA, MAAA

Facilitator(s)

9:00 a.m. – 9:30 a.m.
9:30 a.m. – 11:00 a.m.

Presentation(s): View Presentation

Session Sponsor(s): Health

Competency: Professional Values

Moderator(s): Joe L. Wurzburger, FSA, MAAA

Presenter(s): David M. Dillon, FSA, MAAA; Ben Marshall, FSA, FCIA, CERA, MAAA, J.D.; Joe L. Wurzburger, FSA, MAAA

Experience Level: All

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
Court is in session and you are the jury! Follow along as challenging aspects of actuarial professionalism are explored in a court-like setting. Deliberate based on what you already know from your own experience as well as what you learn in this session, then deliver your verdict accordingly. Who says learning about actuarial professionalism can't be fun?

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Apply actuarial professionalism concepts
  • Identify key ASOPs for health actuaries
  • Explain significant aspects of the US Qualification Standards

 

Session Coordinator(s) Joe L. Wurzburger, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Predictive Analytics & Futurism Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Michael David Hoyer, FSA, MAAA

Presenter(s): Kyle Baird; Shea Kee Parkes, FSA, MAAA

Experience Level: Beginner

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
Big data is an overloaded buzz word, but there are still some important concepts behind the hype. Come learn about concepts like "bring the code to the data" and what "MapReduce" means. We will try to include some live demos of tools such as Apache Spark, and also talk about how these tools might be used in healthcare.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Evaluate usefulness of current big data tools
  • Explain what problems big data tools solve
  • Determine what is just hype

 

Session Coordinator(s) Shea Kee Parkes, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Mark R. Allyn, FSA, MAAA

Presenter(s): Mark R. Allyn, FSA, MAAA; Yang Hu, ASA, MAAA; Mehboob Aziz Khoja, FSA, MAAA

Experience Level: Beginner - Intermediate

CPD: 1.80

Country Relevance: USA

Description:
This session will cover the basic concepts of medical stop loss insurance, the history of self-funding and considerations for an employer. Rating and underwriting examples will be discussed as well as industry trends with respect to claims, products and the impact the ACA has had on the stop loss industry.

Learning Outcomes:
At the end of this session, attendees will have a better understanding of stop loss basics as well as current events in the industry.

Session Coordinator(s) Ashlee Mouton Borcan, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section and Education & Research Section

Competency: Technical Skills & Analytical Problem Solving

Moderator(s): Jason Robert Siegel, FSA, MAAA

Presenter(s): Ian G. Duncan, FSA, FIA, FCIA, MAAA, FCA; Charles S. Fuhrer, FSA, FCA, MAAA; Jason Robert Siegel, FSA, MAAA

Experience Level: All

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
Learn about some of the issues associated with traditional risk adjustment and how these are being handled in next generation models. We will discuss the credibility and variance associated with risk adjusted claims, some of the biases introduced by traditional models and how they can be fixed, as well as how these models can be customized for non-traditional uses such as in provider reimbursement arrangements.

Learning Outcomes:
At the conclusion of this session, attendees will be able to:

  • Describe modern risk adjustment methods,
  • Understand why these changes have occurred over time,
  • Apply these changes to their current work.

 

Session Coordinator(s) Jason Robert Siegel, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: Strategic Insight and Integration

Presenter(s): Anne Jackson, FSA, MAAA

Experience Level: Intermediate - Advanced

CPD: 1.80

Country Relevance: USA

Description:
The Hepatitis C drugs (which provide a cure for most people treated with them) are only the beginning of a wave of highly effective, near-curative therapies. Advances in gene therapy enable stunning success in clinical trial results. This session will explore issues related to these therapies, specifically how to quantify the value they provide and how to align incentives for payers, plan sponsors and patients to pay for these therapies.

Learning Outcomes:
At the conclusion of this session, attendees will be able to describe the tension between plan financials with near-term profitability goals and near-curative therapies that may be priced at the present value of life long alternate treatments.

Session Coordinator(s) Anne Jackson, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Jennifer M. Fleck, FSA, MAAA

Presenter(s): Jennifer M. Fleck, FSA, MAAA; Amy Suzanne Whinnett, FSA, MAAA

Experience Level: Intermediate

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
This session will provide an opportunity for actuaries who practice in the fields of group disability and group life insurance to have an open discussion on topics of current interest, such as pricing, reserving, and experience trends. This session is intended for actuaries currently practicing in these areas; active participation is encouraged.

Learning Outcomes:
Attendees will discuss topics of interest to them and gain perspective on current industry trends and practices.

Session Coordinator(s) Jennifer M. Fleck, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Moderator(s): Dale Games, FSA, MAAA

Presenter(s): Sabrina H. Gibson, FSA, MAAA; Julia Kraemer Lerche, FSA, MAAA; Richard Anthony Marko, FSA, MAAA; Rebecca Owen, FSA, MAAA

Experience Level: Intermediate

CPD: 1.80

Country Relevance: USA

Description:
By 2016, more than half of states had chosen the option to expand Medicaid to cover significantly more low-income adults than ever before. With changing national leadership, this subset of the population (in both expansion and non-expansion states) may lose coverage or obtain coverage elsewhere. We will explore the experience of Medicaid expansion across states, using data to help interpret future impact to Medicaid and commercial health insurance markets.

Learning Outcomes:
At this conclusion, attendees will be able to:

  • Understand the history of Medicaid expansion;
  • Review experience of Medicaid expansion populations nationally; and
  • Discuss potential future options of healthcare insurance markets.

 

Session Coordinator(s) Dale Games, FSA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Marketing & Distribution Section

Competency: External Forces & Industry Knowledge

Moderator(s): Kamran A. Malik, ASA, MAAA

Presenter(s): Ashley A. Flynn; Jennifer O'Brien Howard, FSA, MAAA

Experience Level: All

CPD: 1.80

Country Relevance: Non-Nation Specific

Description:
This session will discuss design, pricing and distribution of critical illness insurance products. It will also combine patient and/or provider perspectives as to how this product helps the consumer when a need arises. Attendees will better understand the need for this product in the marketplace and how carriers can react to this need.

Learning Outcomes:
This session will discuss design, pricing and distribution of critical illness insurance products. It will also combine patient and / or provider perspectives as to how this product helps the consumer when a need arises. Attendees will better understand the need for this product in the marketplace and how carriers can react to this need. Attendees will also hear the story of a cancer survivor and his/her perspective upon diagnosis of cancer as well as challenges faced during treatment.

Session Coordinator(s) Kamran A. Malik, ASA, MAAA

Facilitator(s)

Presentation(s): View Presentation

Session Sponsor(s): Health Section

Competency: External Forces & Industry Knowledge

Presenter(s): Theresa S. Bauer, FSA, MAAA; Jeremiah D. Reuter, ASA, MAAA; Greger J. Vigen, FSA

Experience Level: All

CPD: 1.80

Country Relevance: USA

Description:
This is single workshop spanning two sessions (Sessions 114 and 129) where we will explore the Role of a Healthcare Provider Actuary which was also introduced in Session 99 (note Session 99 is not a pre-requisite for participating in this workshop although it is recommended). In this workshop we will define, explain and provide examples for the three core value based care competency domains that providers need to address as value based care takes a more pronounced role in their organizations. In addition we will link the skills that actuaries bring to bear for providers for these value based care activities as well as provide insights into the various provider roles in which actuaries need to interact to be successful in their positions. Once this foundation has been shared with the audience we will then proceed to exploring the provider actuary's role by reviewing real-world interactive audience case studies. This approach will illustrate the various roles that a provider actuary supports in his/her day to day activities.

Learning Outcomes:
At this conclusion, attendees will be able to:

  1. Define and educate the three value based care competency domains that providers must address to be successful in today's value based care environment.
  2. Provide a deeper understanding for the multiple value based care areas within provider organizations where actuaries can make significant contributions.
  3. Provide real world case studies that highlight the obstacles faced by providers and contributions made by provider actuaries to help the providers make a better business decision.
  4. Identify the anticipated future needs of providers based on the current trajectory of value based care activities.

 

This workshop has two parts; attendees must register for both - Session 114 and 129.

Session Coordinator(s) Jay Patrick Hazelrigs, ASA, MAAA

Facilitator(s)