Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: Risk adjustment (RA) is a key component for CMS Medicare Advantage program and California Medicaid Managed Care program. While both RA programs follow generally accepted basic principles at a high level, their underlying methodologies and assumptions are also quite different. Due to recent events such as COVID-19 Public Health Emergency and Medicaid redetermination delay and restart, it adds complexity to Risk Adjustment. This is a hot topic in the industry and has significant impact to health plans. Keeping current with risk adjustment program changes and understanding the commonalities and differences of these two government risk adjustment programs is important to our health actuaries. Compare these two risk adjustment programs so you can learn key elements of a risk adjustment program, similarities and differences in methodology and assumptions , as well as special considerations due to serving different populations.

Description: Paid Family and Medical Leave (PFML) benefits have expanded rapidly in recent years as an increasing number of states have required employers to provide these benefits to their employees. Examine recent developments in PFML benefits, for example, the presenters will provide information on which states are introducing or considering PFML programs, what types of benefits are provided, what types of data is available to monitor experience, and what challenges programs have encountered.

Description: "Through both informed policy debate and opinionated social media, there are many current event health topics actively discussed and debated. The question remains... how does one separate out subjective information, seek objective analysis, and at the same time consider where there might be more research needed to come to conclusions? This session will use several current event topicsas examples and discover insights as to where research has been performed, what it may or may not cover, and also note where lines are still blurred and may need further details to be studied. Topics that may be discussed include: How valuable and exact is the use of risk-adjustment for Medicare Advantage What is the health and mortality impact of receiving COVID-19 vaccinations"

Description: 2021 ImpACT Conference - Session 1B: Mental Health Care in a Virtual World 10.25.21 Recording

Description: 2021 ImpACT Conference - Session 7E: Impact of COVID-19 on LTC 10.27.21 Recording

Description: Explore SOA-sponsored research on Social Determinants of Health (SDOH) during the How Does Where You Live Impact Your Health webcast. Dive into SDOH data and modeling that will focus on cluster analysis. This will help determine the overall impact of your area's affect on your health and life. This webcast also covers an overview of the existing SDOH-related programs that may affect or intersect with health plan or provider SDOH initiatives. Discover the importance of the place you live and future impact of your overall health.

Description: As we entered 2014, actuaries became familiar with three risk stabilizing mechanisms in the early years of the ACA marketplaces, colloquially known as 'the 3Rs'. As we enter 2024, there is renewed focus on rating compliance and risk adjustment. Speakers will highlight pricing considerations when determining cost-sharing reduction premium loads as well as related issues pertaining to risk adjustment and metal tier pricing.

Description: Analyzing large quantities of raw complex data is often a challenge in the health care industry. During this webcast, there will be a demonstration of how unsupervised machine learning techniques can be applied to such data to help bring useful insights. This will include examples that use unsupervised learning techniques spanning dimensionality reduction, clustering and anomaly detection.

Description: The Child Tax Credit and Social Security have demonstrated how simple rules based cash transfer programs can significantly lower poverty. Discover information from a paper that describes how the expansion of Social Security can more effectively and efficiently reduce poverty than the current alphabet of anti-poverty programs.