Description: Medical and industry experts discuss Acquired Immune Deficiency Syndrome [AIDS], epidemiological projections, mortality and morbidity trends, underwriting practices, solvency and regulatory issues, future outlook, and activities of the Society of Actuaries Task Force on AIDS. From the 1987 Record of Society of Actuaries, Vol. 13, No. 4A.

Description: Presented at October 2001 Annual Meeting. Discusses three key factors related to catastrophic health care events: • Trends in health care delivery and medical technology that are likely to impact catastrophic care costs • Methods of cost and risk control through early identification and specialized medical management • Modeling the cost of catastrophic events on health insurance programs

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: 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: Statement of the American Council of Life Insurers on Pandemic Influenza Preparedness in the Financial Services Sector before the Subcommittee on Oversight and Investigations of the House Financial Services Committee of the United States Congress, June 29, 2006

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

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: 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: This discussion at the SOA 1997 Palm Desert Spring Meeting looks at issues related to second-hand smoke including the negative health effects and underwriting implications.

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.