Description: In this session, you will learn about key cost drivers in pharmacy trends, including but not limited to: New high-cost drugs, including gene therapies, that treat rare and/or expensive conditions such as spinal muscular atrophy (SMA), inherited retinal disease, hemophilia A and B, Duchenne muscular dystrophy (DMD), sickle cell anemia and cerebral adrenoleukodystrophy (CALD) Other cost drivers in the prescription drug category, including the emergence of GLP-1s, digital therapeutics, targeted immunomodulators, accelerated approval drugs and expanded indications The implications of the end of the COVID-19 Public Health Emergency (PHE) on the costs of COVID-19 vaccines, testing and treatment claims Downward influences on pharmacy costs, such as the availability of new generic drugs and biosimilars Emerging trends in pharmacy benefits manager (PBM) contracting, the initial portion of this discussion will be led by a pharmacist and former state pharmacy director.

Description: Arun Paul, FSA MAAA Pricing Actuary for Canada Life Re-Insurance discusses morbidity as it relates to Long-Term Care Insurance. Arun is the current President of SANA The South Asian Network of Actuaries and has over a decade worth of actuarial experience. He provides insights into how morbidity is defined in Long-Term Care insurance and explains the process of filing and processing claims in this engaging discussion with Jon Forster, ASA MAAA Professional Development Learning and Content Design Director at the Society of Actuaries. They also touch upon key factors affecting Long-Term Care insurance costs, such as care duration, benefits administration, and the impact of geographic location and prior claim history on claim costs. Contributors: ARun Paul FSA MAAA, Julite Spector, FSA, MAAA Matt Morton FSA MAAA, RAchael Marsiglio FSA MAAA , Jon Forster ASA MAAA

Description: "It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome. Hear keynote speaker Dr. Ali Mokdad Professor of Health Metrics Sciences at the Institute for Health Metrics and Evaluation (IHME) and Chief Strategy Officer of Population Health at the University of Washington speak about the Global Burden of Disease research and post-pandemic healthcare and mortality impacts. Please note, our previously announced speaker Dr. Anupam Jena had canceled due to unforeseen circumstances.Breakfast is available for all meeting attendees as part of the registration fee. If you plan to attend, please register in advance."

Description: Review a recently completed research project for a multi-stakeholder data consortium on social determinants of health (SDOH). In this project, claims, external SDOH data, geospatial analysis, and machine learning models were used to examine several questions: How to identify SDOH vulnerabilities? How sensitive are the findings with respect to provider coding pattern variations? How much variability in cost can be explained by SDOH vs. morbidity? What are the key risk drivers revealed by machine learning models? The session will review the methodology and main findings from this project.

Description: In this compelling video, Jeanne Cho Stokke delves into the art of effective remote leadership. She eloquently explores the transformative potential of remote work, shedding light on its positive ipacts on team morale and personal well-being. She navigates through the challenges posted by remote work, offering invaluable insights and strategies to navigate and mitigate these obstacles, fostering a thriving and successful team environment. Contributors : Jeanne Cho Stokke, FSA, MAAA, Jon Forster, ASA, MAAA

Description: Focus on how innovative health care organizations develop their value proposition for their intended buyers. Presenters will share information about their specific solution and the methods used to derive credible savings estimates, ROI, and performance guarantees. Learn about data utilized, the methods deployed, advantages, disadvantages, and buyers' reaction. This session is expected to be technical, highly informative, and interactive with audience members.

Description: Learn about key topics affecting actuaries working in the dental insurance space! The session will include valuable information for health actuaries looking to better understand how dental fits into Medicaid, Medicare, commercial, and ACA markets.

Description: This session explores the far-reaching changes to how clinical data will be sourced, processed and consumed in many payer use cases including risk adjustment, quality measurement, care management, claims adjudication, prior authorizations, and other payer functions. Robust, interoperable data exchange is a prerequisite for value-based care. Clinical data will be increasingly accessible to augment administrative (claims) data via standardized Fast Health Interoperability Resources (FHIR, pronounced 'fire'), at a fraction of the cost of a accessing a traditional medical record and in real-time. On May 1, 2020, HHS issued a final rule implementing interoperability and the patient access provisions of the 21st Century Cures Act of 2016, although enforcement has been delayed into 2021 because of the COVID-19 pandemic. The new regulations promote, “HHS’s vision and strategy for achieving a health information ecosystem within which all individuals, their personal representatives, their health care providers, and their payers are able to send, receive, find, and use electronic health information in a manner that is appropriate, secure, timely, and reliable to support the health and wellness of individuals through informed, shared decision-making, as well as to support consumer choice of payers and providers.”Once enforcement begins, CMS and the Office of the National Coordinator for Health Information Technology (ONC), have the authority to mandate adoption of interoperability requirements, and also penalize payers and providers for non-compliance or the delay and withholding of data.This ‘digital transformation’ of the clinical data ecosystem has far-reaching implications for enabling technologies including Natural Language Processing (NLP) and entire segments of services and vendors. It will eliminate many departmental barriers, duplication and error sources for health plans and impact every department and the underlying economics of delivering and managing care.

Description: This session will present results of the most recent SOA/LIMRA studies of variable and fixed-indexed annuity policyholder behavior including withdrawal behavior, guaranteed living benefit elections and surrender activity. Conducted annually since 2006, a discussion on the results of these studies show how they have changed over time, as well as areas where the analysis will need to change or expand. After that, the presenters will focus on dynamic lapse for hot money businesses, which is an important topic for fixed deferred annuity. Key takeaways from this area will include an understanding how to differentiate between hot money and warm money, the different formulas used in the industry, and how to adjust an asset portfolio to protect against the risks associated with hot money businesses.

Description: Back in the day, when data was scarce and computers were slow, actuaries were forced to use simple methods to account for risk. By far, the most common method was to add a margin, usually 5% to a “best estimate” calculation. Remarkedly, this method still works quite well in the aggregate. The problem is that, in many cases, decisions today require a more in-depth analysis. For example, how big a risk is a health plan really taking if it lowers its premiums by 10% to attract more members? This session will discuss techniques for measuring risk in today’s environment. Speakers will also share the results from the 5/50 research project, which forms the foundation for the techniques.