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: "A crucial importance in forecasting is to be able to distinguish cases when temporary slowdowns in health care utilization are followed by a “rebound” period of higher utilization. Come explore an analysis of a new mathematical model describing the return-of-care process. By means of simulation and case studies using the R programming language, the relationship between the visibility of these effects and the endogenous variance of the utilization time series is explored. After attending this session, you will be able to: Describe the parameters and mathematical form of the model Apply the model to real-world utilization data"

Description: Web3, Crypto, and Generative AI are no longer just buzzwords as they reshape the tech landscape. Viewed by many as unconventional technologies, their potential to now revolutionize the insurance industry cannot be ignored. Join us for an enlightening session that delves into the transformative power of these technologies and their current applications within the insurance sector, as well as discover how forward-thinking insurance companies are embracing these tools to unlock innovation and challenge the insurance status quo.

Description: Attend if you are an organization interested in utilizing various kinds of client data to improve the whole insurance sales process, and to develop new applications. Interested parties may include distribution sales force, underwriting, claims, actuarial and finance departments within a typical insurance company, online distribution partners, health care providers and other consulting service providers. The research looks into various use cases, which are typically main issues in modeling in the insurance industry. The research also helps benchmark performance using different languages that may serve as a good reference when best to use a certain language to enhance the development cycle.

Description: There has been a shift in finance and actuarial modernization in the insurance industry over the past 2 to 3 years. Discuss the latest trends in the marketplace and the key changes we see actuaries and actuarial employers needing to make in the future of work. Learn how actuarial work is evolving and about the changing manner in which work is performed. Brainstorm specific ways actuaries can thrive in the future, including performing more strategic work.

Description: Highlight the importance of assigning granular policyholder behavior assumptions to cohorts of a block that behave differently for universal life products. The case study assumption testing will focus on potential cash flow impacts of surrender, lapse and premium persistency behavior— individually and combined. The case study will be based on testing data related to typical demographics for a ULSG product and not on any specific company data.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.

Description: The need for LTC services is projected to increase as the general population ages. Many LTC carriers have helped meet this demand but are looking for new ways to mitigate underpriced risks and to improve policyholders' quality of life. Aging-in-place interventions can be an effective method to mitigate financial risks and improve health outcomes. However, many carriers face challenges to prove financial benefits/ROI, quantify program effectiveness, or simply don't have clarity on how to start and implement these initiatives effectively or operationally.

Description: A three-minute neuroscience-based image exercise is able to accurately unlock the emotional state of individual employees, permitting prediction of a host of specific needs. Actuaries can use this quantitative information at scale to target resources, benefits, and supports to increase the objective wellness and subjective well-being of workforces.

Description: "Explore a general introduction to the opportunity of applying a relatively newer area in machine learning called uplift modeling, which has been successfully used in retail (Wayfair etc). The concepts are parallel to the intervention programs in health care, where we are interested in measuring the treatment effects and ultimately directing the right members to the most effective programs, driving the highest value for the programs both from a financial and health outcomes perspective. Uplift modeling can also be viewed in context of causal modeling where we are interested in assigning cause to a treatment relative to a member not receiving the treatment. Check out an introduction on the concept, seehow it relates and builds on existing work, and use a demo to showcase the potential of integrating this ML approach to current work."