Agenda Day Three
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| Tuesday, June 26 |
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5:00 a.m. – 7:00 a.m.
Check back for further details. The nonrefundable fee of $20 per person. Sign up when you register. Session Coordinator(s) Facilitator(s) |
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6:30 a.m. – 4:00 p.m.
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6:30 a.m. – 7:30 a.m.
Presentation(s): View Presentation Session Sponsor(s): Leadership & Development Section Presenter(s): Jennifer Barley, PCC; Karen Sullivan, MA, PCC Introvert, Extrovert or Ambivert, Oh My! How All Three are Important and Valuable So when it comes to being an introvert, extrovert or an ambivert, which of the three are you? How do you know? How well can you identifying traits in others? And the bigger question is: does it matter? It does. The more you learn about introverts, extroverts and the new kid on the block (no worries we won’t be singing!) ambivert, the more you might realize you’ve misunderstood some of these concepts. Being an introvert, being an extrovert or having a balance of the two get to the heart of who a person is: how they work, how they live and how they interact with people at home or at work. How insightful would it be for you to know which way you lean as well as which way the people you interact with everyday have a tendency toward (although you probably have an inkling) with our “Quiet Quiz” (Hello we at an actuarial conference so of course we have an assessment)? We will also share our “slightly silent” brainstorming technique. This fun breakfast with Jenn Barley and Karen Sullivan of KickStart Your Edge is the perfect mix of interaction as well as reflection, which will give Wheaties a run for their money as the breakfast of champions! This breakfast is open to all meeting attendees free of charge. If you plan to attend, you must register in advance. Session Coordinator(s) Joanne Ryan, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Session Sponsor(s): Actuary of the Future and Predicitve Analytics Section Moderator(s): Douglas T. Norris, FSA, MAAA This event is intended to provide an opportunity for members of the Actuary of the Future and Predictive Analytics and Futurism sections to network with other members, as well as a format to provide an opportunity to discuss hot topics in either/both sections. It is intended for actuaries registered in either section, as well as those interested in either section. This breakfast is open to all meeting attendees free of charge. If you plan to attend, you must register in advance. Session Coordinator(s) Timothy van Laarhoven, ASA, MAAA Facilitator(s) Session Sponsor(s): Long Term Care Section Presenter(s): Robert T. Eaton, FSA, MAAA The LTC Council Section Leadership will provide an update of current happenings and priorities related to 2018 initiatives. This breakfast is open to all meeting attendees free of charge. If you plan to attend, you must register in advance. Session Coordinator(s) Rebecca Tipton, FSA, MAAA Facilitator(s) |
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8:00 a.m. – 9:30 a.m.
Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Leadership & Development Section Competency: Professional Values Presenter(s): Jennifer Barley, PCC; Karen Sullivan, MA, PCC Experience Level: All The workplace can be a hot bed of varying degrees of ethical dilemmas, challenges and situations that show up regularly. A key driver of unrivaled executive presence (which you don’t have to be an executive to actually have) is professionalism. Professionalism is about how you handle situations that come up in the workplace that aren’t your run of the mill, black and white, yes or no answers…sometimes these require you to be outside your comfort zone. In this Get REAL workshop, you will work through sticky situations and discuss how to handle them, hear what the conversations sound like, be able to identify the stories you’re creating and know what to do if you are the lone wolf on the topic. Learning Outcomes:
Country Relevance: Non-Nation Specific Session Coordinator(s) Joanne Ryan, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Education & Research Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Zoe Gibbs; Brian M. Hartman, ASA Experience Level: Beginner–Intermediate This session will examine and compare various ways (both statistical and machine learning) to predict which members will have high claims in a near future year. Very high cost members are rare enough to require large volumes of claims data on a well dispersed population to create a satisfactorily robust actuarial predictive model of their prevalence and severity. This information is not easily available to many of the groups interested in profiling high cost members, such as accountable care organizations, actuaries working for smaller insurers, reinsurers, health economists, independent consulting actuaries and researchers working in an academic setting. With access to multiple large datasets, we are able to begin to answer some questions. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Charles S. Fuhrer, FSA, FCA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Moderator(s): Bryan F. Miller, FSA, MAAA Presenter(s): Jay M. Jaffe, FSA, MAAA; Bryan F. Miller, FSA, MAAA; Stuart D. Rachlin, FSA, MAAA Experience Level: Beginner–Intermediate The year is 2020. Like in 1790, when the US debated where to put its capital, another group of leading citizens has gathered, this time to discuss the nation’s health care crisis. The ACA’s impact is fading and the American economy is still being crippled by the cost of health care. Fortunately, the politicians who have been given the Herculean task of solving the health care crisis have invited a small group of distinguished actuaries to be in “the room where it happens.” The actuaries have been invited as professionals whose Code of Professional Conduct requires them to “act in the public interest.” You are one of the invited actuaries and have been asked to help design an actuarially sound US health system. What do you say? Learning Outcomes: Attendees should gain insight into various opinions of the possible courses the ACA might follow. This would be useful for actuaries in insurance companies, regulatory agencies or those who may need to purchase ACA coverage for themselves. Country Relevance: USA Session Coordinator(s) Bryan F. Miller, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): SOA Competency: Technical Skills & Analytical Problem Solving Moderator(s): Edward C. Cymerys, FSA, MAAA Presenter(s): Frank Cheung, ASA, MAAA; Susan E. Pantely, FSA, MAAA; James F. Walbridge, FSA, MAAA Experience Level: All As new initiatives emerge that are geared toward making it much easier for members to navigate the healthcare system many actuaries would expect utilization to increase. However, some emerging experience is showing plan sponsors with lower trend with services provided in more appropriate settings. Also, new more powerful analytical tools which are able to connect members that engage with the new member decision making support tools with the services that they receive helps give some insight into the drivers behind this result. A panel with an actuary from a start-up implementing this concierge approach, an actuary from Kaiser and an actuary from Milliman with discuss these findings. An article on this topic will also appear in the June Health Watch publication. implementing a concierge approach Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Edward C. Cymerys, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Jennifer M. Fleck, FSA, MAAA; Steve Rulis, FSA, MAAA Experience Level: Beginner–Intermediate A subcommittee of the SOA Group Life Committee conducted a study of group life waiver morbidity and mortality. Jennifer Fleck and Steve Rulis will present the results of the study. Participants will be familiar with the process, findings, analysis, and conclusions of the recently completed SOA Group Life Waiver Study. Learning Outcomes: Participants will be familiar with the process, findings, analysis, and conclusions of the recently completed SOA Group Life Waiver Study. Country Relevance: USA Session Coordinator(s) Leo Tinkham Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Presenter(s): Randall C. Finn, FSA, MAAA; Christin Kuretich, Darrell D. Spell, FSA, MAAA Experience Level: Intermediate Ever since the ACA was passed, there has been upheaval in the supplemental benefits market. This has driven many changes for critical illness and other important supplemental products. Which of these changes are fads and which are actually trends that are driving the market? Join us as we discuss the changes in the market and identify the ones that really matter. Learning Outcomes: Identify key changes affecting the supplemental benefits market. Evaluate the importance of competitor actions. Use the knowledge to help evaluate adjustments that attendees should consider for their own portfolios. Country Relevance: USA Session Coordinator(s) Darrell D. Spell, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Strategic Insight and Integration Moderator(s): Christopher A. Schmidt, FSA, MAAA Presenter(s): Lauren E. Onderisin, FSA, MAAA; Ryder F. Riess; Christopher A. Schmidt, FSA, MAAA Experience Level: All When compared to 10 developed countries, the US ranks last in overall health care performance, highlighted by per capita spending that is 50 percent greater than the next country and last place rankings in efficiency, equity and healthy lives. Escalating costs and decreasing affordability continue to pose the primary challenge in U.S. health care as cost pressures are increasing for all who pay for health care: health plans, governments, employers and consumers. From 2010 to 2015, the average health plan medical loss ratio increased from 86 to 90 percent and average employee contributions to premiums increased by 24 percent. This session will investigate how health plans could bend the cost curve by focusing on solutions such as medical/RX cost reduction opportunity assessments, VBC maximization, PBM relationship maximization, care model redesign, provider/health plan collaboration and next generation product design. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Chris Schmidt, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): SOA and Long Term Care Section Competency: External Forces & Industry Knowledge Moderator(s): John O’Leary Presenter(s): Cindy Malone; John O’Leary; Eileen J. Tell, MPH Experience Level: Beginner–Intermediate This session will present the results of a research project sponsored by the SOA and initiated as a followup to an event held by the SOA for the Long Term Care Think Tank. The SOA engaged MaddockDouglas, Inc. to explore the feasibility of two new product concepts for consumers to finance long term care needs. The research includes qualitative results based on consumer focus group discussions and online surveys of consumers about the concepts. Results also include the derivation of different price points for the product concepts and U.S. sales forecasts in the first two years of introduction. Attendees will have a greater understanding of viability of these proposed product concepts as well as on the ongoing work of the LTC Think Tank. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Steven C. Siegel, ASA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Strategic Insight and Integration Presenter(s): Adam J. Barnhart, FSA, MAAA; Hillary H. Millican, FSA, MAAA; Simon J. Moody, FSA, MAAA Experience Level: Intermediate Risk-sharing arrangements in Medicare Advantage are becoming more sophisticated and prevalent. This session will discuss general considerations when entering into these agreements, common ways to structure these agreements and different perspectives of various parties involved. This session will also discuss the complications surrounding Part D in risk-sharing arrangements. This session is targeted towards actuaries working with providers or health plans in risk-sharing arrangements or those looking to learn more about these agreements. Learning Outcomes: At the conclusion of this session, attendees will better understand risk-sharing arrangements, especially those including Part D. Attendees will be able to identify important considerations in risk-sharing agreements and will be able to apply the information discussed to create more strategic arrangements in the future. Country Relevance: USA Session Coordinator(s) Hillary H. Millican, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Chris Dickerson; Barry Jordan, ASA, MAAA Experience Level: Intermediate The use of health status-based risk adjustment is a common practice in healthcare, in particular for Medicaid programs as part of capitation rate development. With more and more emphasis being placed on alternative payment methods including sub-capitation and incentive arrangements which cover a specific subset of services within the Medicaid program, the use of new or re-calibrated risk adjusters that are geared to predict the utilization of specific services, shows more and more potential. While this is not in itself a new concept, we will be presenting on our findings of calibrating existing risk adjustment products to focus on a specific set of professional services. We will share the results of how calibration of risk adjustment tools towards a specific set of physician services this approach correlates amongst multiple states, as well as discuss some of the potential uses of this approach as states and health plans continue to emphasize effective payment strategies specific to a subset of services. Learning Outcomes:
Country Relevance: Non-Nation Specific Session Coordinator(s) Barry Jordan Jr., ASA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): SOA Competency: Results-Oriented Solutions Presenter(s): Anne Jackson, FSA, MAAA; Jessica M. Naber, FSA, MAAA Experience Level: Intermediate–Advanced The SOA engaged a team at Milliman to evaluate potential risk sharing arrangements between payers and manufacturers related to high cost technologies. This presentation will review key findings from that work effort. We expect to use specific disease areas to compare and contrast the utility of alternate reimbursement approaches and to extrapolate those observations to broad characteristics of disease states and therapies. The project team includes actuaries with US and single payer system expertise. The application of the reimbursement approaches will be evaluated in both contexts. Learning Outcomes: It is unlikely there is a “one size fits all” solution that is ideal for all payer systems and therapies. The purpose of the research, in part, is to identify the risk mitigation offered by the reimbursement approaches and understand how those align to: characteristics of the disease areas and therapies, and payer segments in the U.S. and elsewhere. Country Relevance: International Session Coordinator(s) Anne Jackson Facilitator(s) |
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10:00 a.m. – 11:15 a.m.
Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Presenter(s): Yuliya Babushkina; Warren M. Cohen, FSA, MAAA; Jacob B. Efron, FSA, MAAA Experience Level: Intermediate A significant portion of group disability and life insurance coverages are offered on a voluntary basis, with premiums paid by the employees. Specific plan designs may include fully voluntary coverage as well as core buy-up and supplemental plans. This session discusses a variety of issues related to voluntary plans, including pricing, underwriting, market growth, enrollment and more. Learning Outcomes: Attendees gain an understanding of current issues and challenges in the voluntary group life and disability markets. Country Relevance: Non-Nation Specific Session Coordinator(s) Daniel D. Skwire, FSA, MAAA Facilitator(s) Credits: 1.50 CPD Session Sponsor(s): Marketing & Distribution Section Competency: Strategic Insight and Integration Presenter(s): William S. Bade, FSA, MAAA; Kevin Poynter; Michael Prendes, FSA, MAAA Experience Level: All Hospital indemnity is an area of high growth in the worksite market. As the market becomes more crowded, key players have turned toward differentiation to support top line growth. This session will explore how plan designs vary across carriers, how these differences can create competitive advantages and/or disadvantages, and what carriers should be looking to do in the future to keep up with the fast pace of product development. Learning Outcomes: At the conclusion of the session, attendees will be able to identify the key players and plan designs in the hospital indemnity market, determine the value of benefits within a plan design and design benefit packages that exploit competitive advantages. Country Relevance: USA Session Coordinator(s) William S. Bade, FSA, MAAA Facilitator(s) Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Moderator(s): David M. Dillon, FSA, MAAA Presenter(s): Nancy Atkins; Michael Conway; Allen Kerr; Kent Sullivan Experience Level: Beginner–Intermediate Insurance commissioners will discuss a variety of current topics including health care reform, risks in the major medical markets, voluntary products and other topics. At the conclusion of the session, attendees will be able to identify issues that are on the mind of the regulatory agencies and the different approaches used across the country. Learning Outcomes: At the conclusion of the session, attendees will be able to identify issues that are on the mind of the regulatory agencies. Country Relevance: USA Session Coordinator(s) David M. Dillon, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Alfred A. Bingham, Jr., FSA, MAAA; Syed M. Mehmud, ASA, MAAA, FCA Experience Level: All This session will describe insights gained from studying data from the first three (2014–2016) years of Affordable Care Act data. The data comes from a unique and landmark study led by Syed that collected detailed EDGE data across the nation. The session will describe new tools and techniques deployed to analyze the data, as well as high level conclusions. Learning Outcomes: This session will describe insights gained from studying data from the first three years of the Affordable Care Act. There are wide-ranging views on what it takes to succeed in the tumultuous ACA markets. A large scale and detailed study of ACA experience reveals key insights into that question. Country Relevance: USA Session Coordinator(s) Syed Mehmud, ASA, FCA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Mark M. Zanecki, ASA, MAAA Experience Level: Intermediate–Advanced Actuaries typically estimate insurance liabilities with models focused on triangle development patterns and other assumptions that comprise standard practice(s) of modern actuarial analyses. Advances in computing technology has led to improvements including stochastic methods, finer segmentation and frequent analysis, but machine learning/predictive methods hold the promise of improved accuracy and reliability. By using machine learning/predictive modeling build on GPU servers, we can expect extraordinary advances that will fundamentally transform actuarial analyses in the years ahead. We will begin with a brief overview of advanced modeling methods to estimate claim level liabilities. We'll also review the challenges of claim level analysis and the benefits of claim triage to identify key characteristics early in the analysis of claims. We will then proceed to a review of a first-generation application of machine learning to actuarial reserve analysis. Learning Outcomes: At the conclusion of the session, attendees will be able to:
Country Relevance: USA Session Coordinator(s) Mark M. Zanecki, ASA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Moderator(s): John I. Mange, FSA, MAAA Presenter(s): Lisa Macon Harrison, MPH; Jason W. McKinley, FSA; Sara C. Teppema, FSA, FCA, MAAA Experience Level: All Public health is a rich and vast field that seeks to improve health and health care for all members of society. Actuaries can learn much from public health activities to enhance our practice. Members of the SOA health section public health task force, including public health professionals and actuaries, will review initiatives that can connect public health activities to the actuarial profession. Learning Outcomes:
Country Relevance: Non-Nation Specific Session Coordinator(s) Sara Teppema, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Strategic Insight and Integration Moderator(s): Sabrina H. Gibson, FSA, MAAA Presenter(s): Zachary C. Aters, ASA, MAAA; Sabrina H. Gibson, FSA, MAAA; Mary K. Hegemann, FSA, MAAA; Chris Priest; Michelle L. Raleigh, ASA, FCA, MAAA Experience Level: All Medicaid is always a hot topic! Almost every week there are changes to the program with new waivers being submitted or approved. This session will discuss the rapid changes to Medicaid programs with their implications on actuarial sound rate setting. It will also discuss other important and timely Medicaid topics. Examples of topics that may be discussed are:
Learning Outcomes: Increase knowledge on the recent emerging topics around the Medicaid program. Country Relevance: USA Session Coordinator(s) Sabrina H. Gibson, FSA, MAAA Facilitator(s) Credits: 1.50 CPD Session Sponsor(s): AAA Competency: Professional Values Moderator(s): Audrey L. Halvorson, FSA, MAAA Presenter(s): Matthew P. Chamblee, FSA, MAAA, CERA; Rick Lassow, FSA, MAAA Experience Level: All This session will review new components of ASOPs number 5 and 42 of which health actuaries need to be aware. ASOP 5 is Incurred Health and Disability Claims, and ASOP 42 is Determining Health and Disability Liabilities Other Than Liabilities for Incurred Claims. Practicing actuaries must be aware of all ASOPs so come learn what's new. Learning Outcomes: Professionalism credits for qualification purposes. Understand the changes to the ASOPs number 5 and 42. Country Relevance: USA and Canada Session Coordinator(s) Audrey L. Halvorson, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): David Dobberfuhl, FSA, MAAA; Johann K. Leida, FSA, MAAA Experience Level: All This session is intended to address the impact that risk adjustors can have on value-based payments between payers and providers. We will present case studies to analyze real world examples and illustrate how big of an impact risk adjustment has on the final payment, and how those payments vary by the adjustor used. We will also present possible solutions for this problem. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) David Dobberfuhl, FSA, MAAA Facilitator(s) Session Coordinator(s) Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Long Term Care and Predictive Analytics and Futurism Section Competency: External Forces & Industry Knowledge Moderator(s): Jonathan D. White, FSA, MAAA, CERA Presenter(s): Missy A. Gordon, FSA, MAAA; Brian M. Hartman, ASA Experience Level: Beginner–Intermediate Predictive modeling is no stranger in the world of health insurance. The primary focus of such analysis for medical insurance has been on the near future and disease management. However, this session will discuss how predictive analytics has been used to develop projection assumptions for long-term care insurance by applying experience adjustments to a benchmark. This session will examine how predictive modeling can be used to overcome challenges with traditional actual-to-expected studies and how it produces more statistically robust projection assumptions. It will also explore how to use predictive modeling to understand the range of potential error in the projection assumption and whether emerging experience is deviating materially from your assumptions. The discussion will focus on morbidity assumptions for long-term care insurance, but the concepts can translate to various other assumptions (e.g., mortality) and other lines of business (e.g., disability, life and Medicare supplement) where one wants to experience adjust a benchmark assumption. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Rebecca Tipton, FSA, MAAA Facilitator(s) |
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11:30 a.m. – 1:00 p.m.
Unconscious Bias and Diversity Expert A seminal thought leader on identifying and addressing unconscious bias, best-selling author Howard Ross is one of the nation’s most influential diversity consultants and workplace experts, specializing in corporate culture change, leadership development and managing diversity. The luncheon is included in your registration fee. You may register your guest(s) for the luncheon by including $75 per person with your registration fee. Admission tickets are available for purchase at the meeting as space permits. Refunds will not be given. Session Coordinator(s) Facilitator(s) |
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1:15 p.m. – 2:45 p.m.
Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Strategic Insight and Integration Moderator(s): Christopher A. Schmidt, FSA, MAAA Presenter(s): Gnana K. Kanisan, ASA; Nick Massiello; Christopher A. Schmidt, FSA, MAAA Experience Level: All Inpatient volumes have declined nationally by eight percent since 2008and growth in outpatient and ambulatory services is expected to exponentially increase. This is being fueled by technology advances, payment model pressure and physicians wanting greater control over care provided. Understanding how to identify and prioritize services to shift to cheaper care settings can lead to significant savings for a health plan. A health plan can assess what services could shift and when through episodic analysis, assess if providers have capacity and readiness for accelerated site of service shifts and determine if there are gaps in provider capacity and services. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Chris Schmidt, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Moderator(s): Traci L. Hughes, ASA, MAAA Presenter(s): Kenneth L. Clark, FSA, MAAA; Robert E. Himmelstein, ASA, MAAA Experience Level: Beginner–Intermediate Recently passed legislation referred to as MACRA (Medicare Access and CHIP Reauthorization Act of 2015) will, among other things, affect the Medicare Supplement industry in calendar year 2020. Specifically, the Part B deductible can’t be covered. Therefore, Plan F (in addition to C) will no longer be an option for individuals newly eligible for Medicare starting Jan. 1, 2020. However, inforce policyholders will be able to keep their current versions of Plan F and individuals eligible for Medicare prior to Jan. 1, 2020 (i.e., not “newly eligible”) can purchase the current version of Plan F on or after Jan. 1, 2020. There is the obvious and not so obvious impact on the Medicare Supplement market. The obvious impact is that Plan G will replace Plan F as the primary offering in the market. Not so obvious is that the market for Plan F won't go away completely for several years. In addition, the morbidity shift on respective plans due to changes in applicant profiles will have implications on future experience. The session will discuss the underlying drivers and plausible future scenarios. Learning Outcomes: At the conclusion of the session, attendees will be able to understand the impact of MACRA and determine the key considerations for a given carrier and evaluate the possible directional impact and scale on specific plans. Country Relevance: USA Session Coordinator(s) Kenneth L. Clark, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Moderator(s): Kristi M. Bohn, FSA, MAAA, EA, MSPA Presenter(s): Jan Graeber, ASA, MAAA; Katherine J. Matthews, ASA, MAAA; Stephen P. Melek, FSA, MAAA Experience Level: Beginner–Intermediate This session reviews some of the statistical and regulatory findings relating to mental health parity implementation and particularly focuses on the lack of parity when design and operations come under the lens of actual outcome-based data. As the quantitative and non-quantitative mental health parity requirements apply to nearly all commercial major medical health plansand even some states' Medicaid programs, this session offers a lot of insight (and warnings!) for many health actuaries. Learning Outcomes: At the conclusion of this session, attendees will be able to describe the most likely areas of possible non-compliance with mental health parity, and evaluate plan designs and managed care processes to better ensure compliance in advance. Country Relevance: USA Session Coordinator(s) Kristi M. Bohn, FSA, EA, MAAA, MSPA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Michael Gill; Bethany McAleer, FSA, MAAA; Timothy W. Smith, ASA, MAAA Experience Level: Beginner–Intermediate With advances in cloud computing, led by Amazon's Web Services (AWS), the traditional & structured data warehouse is giving way to the unstructured data lake. The cloud environment provides greater automation of scalable size and processing power. Data lakes in the cloud environment allows for the analytics framework and intelligence to be applied to your raw data in real time, not through the creation of additional data warehouse layers that delay the process. For your downstream analytics, this means greater flexibility in how you store and access your data, faster run times for advanced processes and increased intelligence with the ability to easily integrate non-claims data into your reporting. This session will look at data lakes from a technical perspective, as well as discuss the analytical and actuarial opportunities within the cloud environment. Learning Outcomes:
Country Relevance: Non-Nation Specific Session Coordinator(s) Tim W. Smith, ASA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Sarah J. Chansky, FSA, FCIA; Pete J. Miller, ASA, MAAA Experience Level: Beginner–Intermediate The session will review the history of U.S. mortality and mortality improvement using data from the SOA, Social Security and other reliable sources. The session will pay special attention to causes of recent headwinds to mortality improvement with a special focus on the rise of accidental poisonings as a cause of death. Learning Outcomes: Attendees will become familiar with U.S. mortality and mortality improvement trends over time. The study will distinguish between group life insured population trends and total population trends. Additionally, the study will focus on increasingly common causes of death, such as accidental poisoning, how it is bending the mortality improvement trendline and expectations for future influence on the trend. Country Relevance: USA Session Coordinator(s) Leo Tinkham Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Presenter(s): Ashlee Mouton Borcan, FSA, MAAA; Stephen Rook, FSA, MAAA; Richard D. Schaefer, FSA, MAAA; Joe L. Wurzburger, FSA, MAAA Experience Level: All This session, run in a buzz group format, will allow the audience to discuss a wide variety of important issues from product development, market trends and observations, current and future regulatory environment, statutory and GAAP changes and much more. This session will involve high level of audience participation and interaction. Learning Outcomes: At the conclusion of this session, the audience will have a better understanding of current issues in the supplemental health marketplace. Country Relevance: USA Session Coordinator(s) Ashlee Mouton Borcan, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Professional Values Moderator(s): Jennifer L. Gerstorff, FSA, MAAA Presenter(s): Kevin T. Geursten, FSA, MAAA; Colby R. Schaeffer, ASA, MAAA Experience Level: Beginner–Intermediate Medicaid rate setting involves balancing the needs of multiple stakeholders to produce actuarially sound rates. This session will focus on perspectives of the rate setting process from varying points of view. Key areas of discussion involve:
The format of this session will focus on a brief panel discussion followed by audience questions. Learning Outcomes: At the conclusion of this session, attendees should be able to identify how the ASOPs define and shape Medicaid rate setting. In addition, participants will have a deeper understanding of the various perspectives on the rate setting process, and how to manage differences of opinion in a professional setting. The ultimate goal is to have varying stakeholders within the actuary community to focus on best practices. Country Relevance: USA Session Coordinator(s) Kevin T. Geurtsen, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Moderator(s): Daniel Muldoon, MA Presenter(s): Rebecca Johnson, MBA; Daniel Muldoon, MA Experience Level: Beginner–Intermediate Value-based payment models, including episode and bundled payment models create financial incentives to reduce spending, but they also create concerns over potential stinting of necessary treatments. Often, these models include an explicit adjustment for new technologies or very expensive treatments. In this session, we will present on the Center for Medicaid Services' ONcology Care Model (OCM, which includes an explicit adjustment for novel oncology therapies to reduce the incentive to avoid high cost novel therapies, and also on value-based payment arrangements for Medicaid special needs plans. In this session, we will provide an overview of both initiatives, and we will present claims data analysis that demonstrates how different mechanisms to account for new or expensive treatments can affect participants' performance. This session is intended to meet the needs of actuaries who are focused on all aspects of value-based payment, including the design of alternative payment models and who work with providers to analyze the opportunities that alternative payment models create. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Daniel Muldoon Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Results-Oriented Solutions Moderator(s): Kelsey L. Stevens, FSA, MAAA Presenter(s): James P. Hazelrigs, ASA, MAAA; Aaron P. Jurgaitis, ASA, MAAA; Jeremiah D. Reuter, ASA, MAAA; Juliet M. Spector, FSA, MAAA Experience Level: Beginner– Intermediate This session will consist of real-life learnings and discussions that relate directly to the SOA ‘Value-Based Care’ initiative - The Role of the Health Care Provider Actuary, a Strategic Initiative of the SOA Health Section. The initiative’s focus is on building the necessary foundation for health care actuaries to support health care providers in managing their value- based care arrangements. See the article “Value-Based Care: The Role of the Health Care Provider Actuary” in the February 2018 edition of Health Watch for further information. The learnings will be delivered by a panel of experts who support providers in a multitude of subject areas. Learning Outcomes: Attendees should have a better understanding of the current provider environment and how their business is changing as a result of external influences like ACA, MACRA, etc. They should walk away with a clear understanding of the skill sets (high level) that are needed for providers to be successful in the new VBC world, particularly which of these skills are currently being fulfilled by actuaries and which are expected to increase in demand in the future. Country Relevance: USA Session Coordinator(s) Gregory G. Fann, FSA, FCA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Results-Oriented Solutions Moderator(s): Joseph P. Slater, FSA, MAAA Presenter(s): John L. Culkin, ASA, MAAA; Ian G. Duncan, FSA, FIA, FCIA, MAAA, FCA; Douglas T. Norris, FSA, MAAA Experience Level: Intermediate–Advanced A panel of health insurance actuaries will describe their policy proposals to reform the individual ACA market and make it the stable and sustainable Individual Health Insurance marketplace that covers the largest number of people at the lowest possible cost. Policy provisions discussed could include high risk pools, revised age curves, changes in the coverage and benefit mandates, etc. Learning Outcomes: At the conclusion of the session, attendees will be able to:
Country Relevance: USA Session Coordinator(s) Joe P. Slater, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Elena V. Black, FSA, EA, MAAA, FCA; Yi-Ling Lin, FSA, MAAA, FCA Experience Level: Intermediate In health, complex business problems are being tackled with a wide range of predictive analytics techniques, from traditional risk assessment linear regressions to innovative machine learning methodologies. One such example is applying a gradient boosting machine (tree-based) learning technique to predict a population’s health plan elections amongst a menu of available plan options and pricing. Exploring and understanding mathematical underpinnings of methodologies, utilized in predictive analytics, is one necessary step in harnessing the power of this new actuarial toolbox. Demystifying the “black box” is necessary but not sufficient. An entire chain of necessary steps is required: formulating relevant business problems in the right way, understanding and visualizing the data and potential trends, applying appropriate optimization tools, and finally, interpreting modeling results to solve the business problem at hand. In this session, we illustrate these steps through case studies. We will discuss the attributes of business problems in health area that can greatly benefit from sophisticated machine learning and other analytical techniques. We demonstrate how these algorithms are applied, leading to results that aid in an informed decision-making process. We will show how data exploration and visualization can lend a powerful hand in understanding not only your data but modeling results. Learning Outcomes: At the conclusion of the session, attendees will be able to:
Country Relevance: USA Session Coordinator(s) Yi-Ling Lin, FSA, FCA, MAAA Facilitator(s) |
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2:45 p.m. – 3:15 p.m.
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3:15 p.m. – 4:30 p.m.
Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): William S. Bade, FSA, MAAA; Chase Pettus Experience Level: All According to the Mayo Clinic, research has shown that sitting behind a desk or wheel of a car/truck significantly increases the risk of cardiovascular disease. This session will use data to explore this hypothesis as well as other common assumptions in the context of worksite accident, critical illness, and hospital indemnity products. In addition, the session will provide an overview of important diagnosis codes and how an understanding of diagnosis coding can be combined with medical data to revolutionize product pricing. Learning Outcomes: At the conclusion of the session, attendees will be able to demonstrate knowledge of common diagnosis codes, identify specific pricing issues in the worksite market and develop solutions to specific pricing issues in the worksite market. Country Relevance: USA and Canada Session Coordinator(s) William S. Bade, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Strategic Insight and Integration Moderator(s): Kevin Sigman, FSA, MAAA Presenter(s): Eli Greenberg, ASA, MAAA Experience Level: All Orthopedic related costs are a consistent cost driver for health plans. It is estimated that seven to 10 percent of adults suffer from back pain. This analysis focuses on the treatment sequence after the initial diagnosis of back pain with a focus on contrasting the behavior of patients who end up having surgery versus those that avoid surgery. The analysis incorporates considerations related to place of entry into the healthcare system, treatment options, drug use and demographics. Ultimately the analysis leads to the key member decisions and decision timing as well as the employer design opportunities that exist to optimize this treatment sequence. Learning Outcomes: At the conclusion of this session, attendees will be able to:
Country Relevance: USA Session Coordinator(s) Eli Greenberg, ASA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Results-Oriented Solutions Moderator(s): John I. Mange, FSA, MAAA Presenter(s): Kristi M. Bohn, FSA, MAAA, EA, MSPA; Hobson D. Carroll, FSA, MAAA; Mehboob A. Khoja, FSA, MAAA; Brent W. Seiler, FSA, MAAA Experience Level: Intermediate In 2017, the Health Section’s Strategic Initiatives Committee formed the Self-Insurance Task Force (SITF). In this session, the SITF presents its white paper that was written by actuaries working in the self-insured industry for health actuaries unfamiliar with self-insurance in areas such as regulation, consulting and risk mitigation, including stop-loss insurance. The white paper explains what it means to self-insure and delves into topic areas such as self-insurance terminology, advantages and disadvantages of self-insurance and issues the benefits consulting actuary should address before recommending to their clients that they consider self-insuring their employee benefits plan. The white paper also describes risk transfer tools from the perspectives of both the plan sponsor and the stop-loss insurer, including potential coverage gaps, rating, underwriting, reserving and corporate product strategies. Time will be allowed for questions or comments from the audience. Learning Outcomes: Attendees will understand the:
Country Relevance: USA Session Coordinator(s) Hobson D. Carroll, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): SOA Competency: External Forces & Industry Knowledge Moderator(s): Deana K. Bell, FSA, MAAA Presenter(s): Deana K. Bell, FSA, MAAA; Nancy J. Hubler, ASA, MAAA, Annette V. James, FSA, MAAA, FCA Experience Level: Beginner– Intermediate This session will describe best practices in the preparation of the actuarial memorandum that supports the actuarial opinion that is part of a health annual statement. Presenters will discuss the components of an actuarial memorandum, what it means to provide sufficient documentation and disclosure for another actuary practicing in the same field to evaluate the work. Learning Outcomes: At the conclusion of this session, attendees will be able to prepare an actuarial memorandum that meets the requirements set forth in the NAIC Annual Statement instructions and meets the needs of many regulators and other users of the actuarial memorandum. Attendees will understand the critical elements regulators look for and what level of detail to include supporting each item in the opinion. Country Relevance: USA Session Coordinator(s) Nancy J. Hubler, ASA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: Technical Skills & Analytical Problem Solving Presenter(s): Jeffrey S. Bowden, FSA, MAAA; Mark J. Costello, FSA, MAAA Experience Level: Beginner– Intermediate Attendees will learn about the various uses for predictive models in disability insurance. Panelists will discuss both theoretical approaches and actual applications in beta or production today. The session will explore text mining in the management of disability claims and text mining in evaluating medical records. The session will discuss the use of multivariable in disability pricing and risk selection. Learning Outcomes: Participants will understand theoretical and applied approaches to using predictive models to supplement various functional tasks in the disability insurance business. Country Relevance: USA and Canada Session Coordinator(s) Leo Tinkham Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Joint Risk Management Section Competency: Strategic Insight and Integration Moderator(s): Marcus A. Such, ASA, MAAA Presenter(s): Manchiu Chan, FSA, MAAA: Marizze C. Seeth, ASA; Christopher Suchar, FCAS, MAAA Experience Level: Intermediate Most states have adopted NAIC Own Risk Solvency Assessment (ORSA) model act since it went into effect in 2015. Insurance companies meeting the premium threshold must submit ORSA reports to their respective regulators. A well-structured Enterprise Risk Management framework plays a critical role helping companies prepare for ORSA and mitigate through today’s rapidly changing market and regulatory environment. Meanwhile, Economic Capital Models (ECMs) are emerging as a tool which is better suited for an assessment of risk capital and prospective solvency that not only satisfies ORSA requirements, but also positions a company to go beyond that to help support better management decisions around capital allocation. With a focus on health insurance companies, this presentation will review:
Learning Outcomes:
Country Relevance: Non-Nation Specific Session Coordinator(s) Mario E. DiCaro, FCAS, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Moderator(s): Jim Toole, FSA, MAAA, CERA, FCA Presenter(s): Alison Hare; Jennifer A. Horney, Ph.D., MPH; Robert Morrow, MD Experience Level: All Recent weather disasters such as Hurricane Harvey have highlighted the importance of public health activities and vulnerabilities of communities after a disaster. Post-disaster public health experts will discuss this important topic at the intersection of public health and risk. The session will outline the various vulnerabilities that disasters expose: physical, social, environmental and where these overlap. It will discuss risks to communities, as well as community resilience and recovery efforts. Finally, it will review the impact on health care providers and payers. Learning Outcomes:
Country Relevance: Non-Nation Specific Session Coordinator(s) Sara Teppema, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.80 CPD Session Sponsor(s): Health Section Competency: Strategic Insight and Integration Moderator(s): Marilyn M. McGaffin, ASA, MAAA Presenter(s): Sean Karbowicz; Gregory L. Warren, FSA, MAAA, FCA Experience Level: Beginner-Intermediate This session defines pharmacy transparency and delves into how it can be used to complement conventional pharmacy management programs. The session will discuss how to engage both consumers and providers in the use of pharmacy transparency models. The speakers demonstrate methods to assist with value based care for pharmacy – getting the consumer, pharmacist and physician to work together to define the right treatment for the individual to achieve better drug adherence, resulting in more engaged consumers, better health outcomes and provider loyalty. This session will also discuss methods to measure impacts of pharmacy solutions on claims and how to translate these cost savings into lower premiums. Learning Outcomes: At the conclusion of the session, attendees will be able to identify pharmacy transparency and solutions. The attendee will be able to explain how pharmacy transparency helps with value based care and be able to evaluate these cost savings into lower premiums. Country Relevance: USA Session Coordinator(s) Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): SOA Competency: External Forces & Industry Knowledge Presenter(s): Drew Kirchner, FSA, MAAA; Keith R. Klimek, FSA, MAAA Experience Level: Beginner – Intermediate The session will have three primary sections. The first section will define biosimilar pharmaceuticals, introduce key nomenclature and explain how these products are typically utilized and reimbursed. The second section will describe potential scenarios regarding the cost trends in a therapeutic class if a biosimilar enters the market. The third section will summarize the presentation and explain how to use the information for collaborating with trade relation departments and forecasting medical cost trends. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Keith R. Klimek, FSA, MAAA Facilitator(s) Presentation(s): View Presentation Credits: 1.50 CPD Session Sponsor(s): Health Section Competency: External Forces & Industry Knowledge Moderator(s): James P. Hazelrigs, ASA, MAAA Presenter(s): Aaron P. Jurgaitis, ASA, MAAA; Kelsey L. Stevens, FSA, MAAA Experience Level: Intermediate In an effort to reform how health care is delivered and paid for, value-based programs are intended to incentivize providers to focus on the quality of care, rather than the quantity of care, that they provide for their patients. Medicare has been a leader when it comes to tying payment to value. This session will provide an overview of some of the payment and delivery system reforms that exist in Medicare today. It will evaluate early indicators of improvement in patient outcomes and reduction in medical costs. Finally, it will explore the future direction of the major programs offered directly through CMS and through the Center for Medicare & Medicaid Innovation. his session is intended to meet the needs of actuaries who are focused on value- based design and/or Medicare. Learning Outcomes:
Country Relevance: USA Session Coordinator(s) Kelsey L. Stevens, FSA, MAAA Facilitator(s) |
Howard Ross