Description: The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. The presenters will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. They will also provide concepts to help manage the coming wave of gene and cell therapies.

Description: While intended to assist health plan actuaries responsible for stress testing and ORSA filings, this session will also be informative for actuaries interested in communicating the impact of potential catastrophic events for health plans to their management and board. It will begin with a discussion of event thresholds for stress tests and their impact on capital and financial statements. Presenters will take a detailed look at several catastrophic event case studies (historical and hypothetical) in the following areas: healthcare specific (e.g. pandemic, specialty Rx), financial institution/credit market, operational/business, strategic and multi-event scenarios.</

Description: Telehealth enables the delivery of health care services to patients that are not in the same location as providers. Over the past decade, telehealth has been used increasingly to complement face-to-face patient encounters, and is particularly important to addressing health care needs in rural areas. Recent regulatory catalysts, particularly in the Medicare Advantage program, have served to elevate the visibility and importance of telehealth in the overall health care delivery system. Starting in 2020, Medicare Advantage plans can offer any clinically appropriate physician services through telehealth as part of the standard Medicare benefit. Network adequacy standards can also be met via telehealth providers under certain programs. This presentation will cover the basics of what constitutes telehealth, and provide tangible demonstrations of telehealth technology (simulating variations mediums through which services are delivered). We will cover the what, the why, and the where (anywhere) of telehealth in 2020.

Description: Technical report to accompany Fifty States, Fifty Stories: A Decade of Health Care Reform Under the Affordable Care Act.

Description: Summary in Simplified Chinese

Description: This report provides highlights of a weekly survey of practices regarding the mitigation of the spread of COVID-19 in the U.S. during the week of November 28, 2020. The survey asks about the degree to which the respondents perceive that people in their community are following 21 common mitigation practices. The responses are separated by state and compared to state level statistics regarding the level of COVID-19 infections from the Johns Hopkins COVID database for the same time period.

Description: The diary of Dirk Nieder, an actuary who traveled in Asia amid the COVID-19 pandemic, tying in what he saw in asia countries and developments from the west.

Description: The Society of Actuaries (SOA) published its first COVID-19 research brief on March 10, 2020, followed by regular updates and expansions through June 12, 2020. The comprehensive report includes a section of Key Statistics. On July 24, 2020, the SOA released a report showing updates through July 22 to selected graphs from or related to the Key Statistics section of the comprehensive report. This report provides similar updates through August 9, 2020.

Description: This report has been written to provide a primer on the measurement known as R0 (pronounced “R-naught”), which is commonly used in epidemiology. The R0 metric has received extensive press coverage since the outbreak due to its importance in the measurement of the spread of COVID-19.

Description: Electronic Health Records, or EHRs, are a major worldwide initiative to eliminate paper recordings – including Attending Physician Statements (APSs) – of an individual’s medical history and current treatment.