Description: The Triple Aim is a vision to improve the health of populations, create a better quality of life, and reduce per capita spending for the benefit of communities.(http://www.ihi.org/Topics/TripleAim/Pages/default.aspx) While much public attention on wellness has focused on topics such as obesity and smoking, it would be beneficial if greater emphasis was placed on raising the bar of oral health. The mouth plays an important role in overall health and wellness. Routine oral care helps prevent dental problems and appears to positively affect chronic conditions before they develop into complex, more expensive ones. This purpose of this session is to increase awareness of the importance of oral health, the consequences of poor oral health, and the link with socioeconomic characteristics. This session will explore and highlight studies completed in this space by both researchers and payers. Actuaries interested in learning more about the impact of oral health and overall health, relevant interventions that have been undertaken, areas for potential financial savings, and issues relating to public policy applicable to oral health would benefit from attending this session.

Description: This is a case study session where the speakers will describe a project where a major health system converted its provider distinct reimbursement (i.e., separate physician IPA and hospital capitation) to an integrated reimbursement involving global capitation. The session will discuss the strategic issues considered by the parties and how they evaluated them in their decision process. This session will provide attendees an example of how to approach this type of decision.

Description: There have been a variety of proposals related to expanding eligibility for Medicare, ranging from a publicly funded program to a full buy-in option. This session will explore the actuarial implications of various buy-in proposals and the potential impact that such policy changes could have on the health care market landscape. In particular, we will discuss the ways in which program eligibility requirements, plan designs, provider reimbursement arrangements, network design, rating rules, and subsidies could affect premium levels and membership volume in a Medicare buy-in market, as well as the potential side effects on providers and existing health care markets.

Description: The session covers strategies and products health plans are developing to address consumer choice. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 121

Description: On December 21, 2018, the Centers of Medicare & Medicaid Services (CMS) released the final rule for Accountable Care Organizations (ACOs) in the Medicare Shared Savings Program. 'Pathways to Success' makes sweeping changes and will push ACOs to assume financial risk more quickly. This session will discuss the key changes in the final rule, reasons why providers would remain in the program while being forced to downside risk, and how actuaries can add value to providers who will be taking on millions of dollars of risk in the coming years.

Description: Principal Analyst Laurie M. Orlov of the Aging in Place Technology Watch will present a roadmap for the technology and ITSS marketplace. She will explore where it has been, what it does best, where it is going, and the challenges it faces. She has been a leading researcher and independent analyst in this field for more than 20 years.

Description: 2004 SOA Annual Meeting and Exhibit, New York. This session addressed the consolidation in the industry and the associated impact on the relationship between the ceding company and its reinsurers.

Description: 1999 SOA Annual Meeting, San Francisco. Presenters examined alternative marketing methods that bridge buyers and sellers. Subjects discussed: 1. Work-site marketing. 2. Nontraditional marketing survey presentation. 3. Marketing through property and casualty agents.

Description: Predictive modeling is a powerful toolset for assumption setting (mortality, lapse, etc.). The multivariate approach has its advantages in handling high-dimensional data, address correlations, and statistical significance. However, building insurance assumptions is far more than a simple modeling practice. One must take care to address how the model is applied and its business implications. This session will share the learnings from multiple projects.

Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.