Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: This session series is sponsored by Zelis Shifting utilization of health services to efficient and high-value providers presents an opportunity to reduce harmful cascades of wasteful spending, ultimately freeing up funds for additional high-value services that will improve quality and member satisfaction. Identifying the right providers to put at the center of networks is challenging for any health care organization. How can you objectively determine which providers are delivering the greatest value when compared to their peers? And once those providers are identified, what’s next? Join Zelis and their partner HealthCorum to review a case study on a shared services organization where they leveraged statewide multi-payer claims data to produce provider level analytics, allowing for transparency into provider practice patterns at a granular level. By attending this session, you will be able to: - Create a fair methodology to benchmark providers. - Develop metrics and scores to identify high-value providers. - Produce actionable data to be used for network optimization strategies.

Description: Is your development team or IT staff growing tired of last-minute requests to include additional functionality? Have you strained to explain challenging actuarial topics to non-actuarial staff for implementation? Do your teams find themselves revisiting deadlines & timelines when building solutions? During this interactive panel discussion, three technologists (two software engineering managers and one data scientist) along with three actuaries will discuss real world problems and approaches using experience from previous projects. Although the challenge of running efficient software teams is not unique to actuarial science, this webcast will discuss best practices on how to organize teams to reduce friction and context switching. Presenters will also explore unique actuarial challenges and concepts including how to address standards on data quality when building software, how to build intuitive software that meets actuarial standards and how test-driven development makes it easier to meet actuarial standards of practice.

Description: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

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: Gather with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, pension, investment, product strategy, and more.