Description: On average, contracts receiving their first star rating receive 3.20 stars, compared to existing or established contracts receiving 3.90 stars on average. This 0.70 disparity in quality ratings creates significant hardship on new contracts when this lower star rating decreases their payments in the following calendar year. This article explores the disparity in Medicare Advantage Star Ratings between contracts receiving their first star ratings (“New” contracts) and existing contracts, including: 1. Understanding what happens to Medicare Advantage Payments when contracts receive lower star ratings? – What is the Star Rating cliff and why does it matter to new contracts? 2. Explaining when a contract receives their first star rating and how much enrollment this requires – When does the Star Rating cliff occur? 3. Noting which specific star measures “New” contracts struggle with, including those contracts under large parent organizations, contracts with rapid growth, and all other new contracts. – How can my contract avoid the Star Rating cliff?

Description: Many new and innovative companies are leveraging technology to improve the effectiveness of the care provided to patients. They are employing better tools to identify patients who can benefit from specific programs that best meet the patient's need. They are also dramatically increasing the use of these programs by guiding plan members through the maze of offerings to match them with the programs that will be most beneficial to them. Employers are making these third party programs available to their members and Medicare Plans are using these new tools to identify emerging health risks for early intervention and more accurate risk scoring. This session will explore some examples of these programs, how they are being effectively integrated into the operations of health plans and how the results of these programs are being measured.The speakers will be:Raj Behal, MD, MPH,Chief Quality Officer, One Medical. Raj leads the quality and safety, value and innovation, and data science teams at One Medical. One Medical is changing the way primary care is delivered with a concierge approach with technology seamlessly woven into their offering. This includes booking appointments on line, virtual face to face care, accessible medical records and health reminders.Mylea Charval,Ph.D., CEO and Founder, Savonix. Savonix is a next generation cognitive assessment platform that brings clinical, evidence-based, and all mobile digital assessment of cognitive and emotional function. These capabilities are critical for early identification of the onset of dementia and for the proper risk assessment of seniors enrolled in Medicare Advantage Plans.Ed Cymerys, FSA, Advisor. Ed will serve as moderator. Over the last six years Ed has served as an advisor to a number of early stage technology companies looking to improve the way health benefits are being delivered.Dave Sotelo, FSA, MAAA, Actuarial Manager, Collective Health, Inc. Collective Health is an integrated solution that allows self-funded employers to administer their health plans, control costs, and take care of their people -- all in one place. They have effectively integrated more than 70 distinct third party solutions for self-funded employers and are rigorously assessing the impact of these programs

Description: Actuarial Perspectives on COVID-19: June 10 Twitter Chat with the Society of Actuaries

Description: The Living to 100 monograph is composed of the papers, essays, panel discussions, teaching and keynote sessions presented at the symposium.