Description: Summary of research from the Initiative 18/11 - Pharmacy team about the drug development process for traditional pharmaceuticals: Who does the research and discovery? What does the research and discovery process entail? How are targets identified and validated for research and discovery? What are clinical trials and how are they conducted? How is the drug development process regulated? How is the drug development process funded?

Description: CMS provides a significant and growing amount of information that can be leveraged by actuaries. Between the public use and research files CMS makes publicly available, large amounts of information that can be assimilated to help understand the who, what, when, where and how of Medicare. With the CMS allowance of supplemental benefits to address SDOH, adding SDOH data into your data landscape is critical to better understand your members' cost drivers. The presenters will focus on the depth and breadth of data available, summarize any restrictions on the use of the data, and identify areas where access to the new data can provide more meaningful insights.

Description: This session will cover the definition of a risk-taking health entity, the kinds of risk and ways to measure it. Included is an update from the Risk-based Capital Task Force. From Record of Society of Actuaries Vol. 20, No. 3B.

Description: The proposed session will introduce Outcome Based Risk Sharing Arrangements (“OBRSA”) between health insurance payers (“payers”, including insurance companies, health plans, sponsored employers, and government programs) and pharmaceutical manufacturers (“pharma”), and it’s intended to meet the needs of actuaries who focus on pharmacy benefits and risk sharing arrangements. The covered content will include (1) the background of OBRSAs, definitions, stakeholders, and OBRSA’s role in shifting the system from volume-based toward value-based; (2) conflicting perspectives about OBRSAs between payers and pharma (cultural and methodological); (3) identification of incentive gaps between payers and pharma, and incentive alignment between them; (4) barriers to implement OBRSAs; (5) limitations and considerations of OBRSA implementation; and (5) hypothetic OBRSA examples.

Description: Ignite presentations feature speakers with 20 slides which automatically advance every 15 seconds. The result is a fast and fun presentation which lasts just five minutes. The first portion of this session will feature public health experts doing Ignite presentations with particular focus on social determinants and health disparities. Then stick around for the second portion when all of the presenters take part in a moderated, talk show-style discussion. You'll get a chance to ask your questions and dig deeper into the topics you just heard about. Be prepared for a fast-paced, thought-provoking session that you'll remember long after it ends!

Description: Vast sums of private equity are flowing into start-ups intent on lowering healthcare trend. This presents a huge challenge for insurance company actuaries to stay current on such start-ups and the innovations they're advancing. Further, it can be overwhelming to evaluate the many vendors eager to sell their services to the company. This session will provide an overview of the start-up and private equity process, review some of the emerging innovators, and discuss approaches to evaluate their Return on Investment (ROI) as efficiently as possible.

Description: This session discusses the benefits of actuarial involvement in understand. Topics include current methods [such as teleunderwriting, use of pharmacy data] and the benefit versus cost of using various underwriting tools. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 22

Description: This session discusses how many carriers use simplified underwriting techniques or alternative underwriting approaches to streamline the underwriting/policy issue process. From the Record of the Society of Actuaries, Volume 27, No. 3, Session 130

Description: This session at the SOA 1990 San Francisco Spring Meeting focuses on AIDS including an update on the epidemic and discussion about the actuarial implication of four case studies.

Description: This session is about health risk adjusters and includes a discussion on risk assessment, actuarial applications, New York small-group reform, medical management applications, Rand 36, and other methods. From Record of Society of Actuaries Vol. 19, No. 4B.