Description: Read the November 26 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: The collective investment in transforming the life insurance proposition exceeds anything seen in the last thirty years — a working lifetime. As one would expect, reinsurers are playing a major role. The past five years have seen global reinsurers raise the bar on client experience to new levels, while also investing, expanding and re-organizing to support the transformation of the primary insurance industry, and in so doing also their own.

Description: Recently, actuaries have become more involved in formulary decisions due to high and variable pharmacy cost and utilization trends. How can actuaries and pharmaceutical manufacturers work together to better predict the market while covering key drugs? What discussions are currently taking place between manufacturers and payers? Is there value in these discussions that actuaries are missing? This presentation will provide both actuarial and manufacturer perspectives in order to create a mutual understanding that will begin to direct future conversations to benefit both stakeholders.

Description: Read the November 14 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Support systems and new solutions to enable caregivers to deliver better care and reduce personal stress.

Description: Shared savings deals are all the rage these days. Significant numbers of payers and provider groups in many markets around the U.S. want to engage in shared savings contracts covering commercial, Medicare and Medicaid patients. The fundamental question underlying a value-based contract is, for whom is the value accruing? Ostensibly, value is accruing to the sponsor—whether employer or public payer—but should be accruing to the provider as well. Often design flaws in value-based arrangements and contracts and/or the inability to execute in a value-based paradigm diminish the savings that could have accrued, create inequities in value or drive unintended consequences. This presentation will provide attendees with insights into how to design a workable value-based payment initiative, how to educate both payer and provider participants, and how to oversee the initiative’s operations. Specific topics will include: • Attribution logic: prospective, retrospective and the details in between • Risk adjustment: why one model doesn’t fit all arrangements, and even if it does, how do you implement? • Data and reporting: matching business needs to the payer’s willingness to be transparent and provider capabilities • Quality improvement as a component of payment: actionable and tied to the attributed population or just “out there?”

Description: The SOA Reinsurance Research Section is seeking proposals on Mortality Improvement Independ – Independent Analysis. Mortality improvement is an important assumption for projecting future liability cashflows and has a material financial impact on a company. Mortality improvement is a hot topic in the industry and companies show significant interest in understanding the key factors that differentiate mortality improvement. The focus of this research is to gain a better understanding of the main drivers of mortality improvement:

Description: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: Creating the complete view and management of the complex interactions between care providers, medicines and behavior.