Description: The National Association of Worksite Medical Clinics reported that one-third of U.S. employers with 5,000+ employees sponsored worksite (onsite) health care centers in 2017, and 24 percent of employers with 500-4,999 either have or plan to implement onsite health care by 2019. This session will explore why onsite health care programs are gaining traction: • Why do employers sponsor onsite healthcare? • What objectives do they hope to achieve? • How does the evidence compare with these objectives?

Description: Insurance commissioners and/or deputy commissioners will discuss a variety of current topics including health care reform, risks in the major medical markets, voluntary products and other topics. At the conclusion of the session, attendees will be able to identify issues that are on the mind of the regulatory agencies and the different approaches used across the country.

Description: This session will review the challenges the Affordable Care Act has faced since its enactment in 2010 and will look forward to where it’s headed in the future. Panelists will discuss current ACA legislative and regulatory activities as well as ongoing ACA litigation.

Description: The U.S. health care industry has gone through a dramatic change during the past several years. The business model has moved from a risk selection model to a risk management model. People can shop online for their health care coverage. Everyone is welcome! Annual and lifetime dollar limits, underwriting and the pre-existing conditions exclusion are all in the history book now. Facing the challenges of the post-reform era, many health insurance carriers began using big data analytics on all aspects of their decision-making processes. The goal is to be able to compete on analytics in this quickly changing environment. However, becoming an analytics competitor is not easy. It requires the belief from the leadership and a group of dedicated analytical professionals to solve emergent business problems that existing strategies cannot address in an evolving market. These problems include marketing for acquisition and retention, coding accuracy, revenue growth, health care disparity, payment integrity, quality of care, health care cost reduction and, ultimately, personalized care management. In this section, audience will learn a basic understanding of the role of predictive analytics in US Healthcare marketplace.

Description: Medicare-Advantage Organizations (MAOs) are often under intense pressure to increase revenue. The ACA dramatically changed the incentives by which MAOs achieve financial success. With benchmark rates growing only as fast as FFS Medicare rates, many MAOs rely on risk scores and quality bonuses as their primary source of additional revenue.There are a not insignificant number of MAOs that are either under scrutiny by federal investigators, exposed to whistleblower lawsuits, and some even paying large penalties to resolve False Claims Act liability for providing inaccurate risk adjustment information (e.g., $270 million paid by Healthcare Partners/DaVita Medical Holdings in October 2018).Is it possible to operate a risk adjustment program that is both compliant with applicable federal regulations and sub-regulatory guidance yet still generate the revenue to ensure that Medicare-Advantage plans are financially viable in the marketplace? The presenters believe that not only is true compliance (as opposed to the mere appearance of a compliance program) a requirement for success, it is a necessary pre-condition for both MAO profitability and to ensure that risk scores are an accurate representation of member morbidity.

Description: Companies with the intention of being the top, trusted source(s) in an information overloaded world.

Description: Life insurance carriers increasingly enhance their product offerings with combination products, aka hybrid or combo products, or living benefits. Presenters will discuss the growth in this market, consumer perception and distribution needs, highlight the key features of long-term care (and chronic illness) and critical illness benefits, and posit what the future of this market will bring.

Description: This session will cover the latest developments of the Medicaid Final Rule proposed changes and their implications going forward.

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: Dental care is an important component of everyone's health, and senior citizens are no exception. With no public dental coverage under traditional Medicare, seniors must seek other ways to obtain dental insurance, pay for services out of pocket, or go without care. In this session we will review the importance of oral care to overall health, the current state of public and private dental insurance for seniors, and innovative ways to reach this population. Medicare, Medicare Advantage, Medicaid, and other types of dental coverage will be discussed by three actuaries with different areas of expertise in the senior dental market.