Description: What is the value of the health care we pay for? As medical inflation continues to outpace general inflation, this question is more important than ever. As actuaries, we are often called upon to evaluate the value of medical care. Are the ways the value equation is commonly constructed reflective of our aspirations as a society? What gravitational forces do we need to be aware of that perpetuate the status quo, mental biases and methodological pitfalls and how do we actively work to correct for them?

Description: This webcast will explore the shifting landscape of healthcare costs. It will cover healthcare trend basics, recent developments, and what’s ahead. Drawing from comprehensive data analysis and industry insights, this presentation promises to equip attendees with actionable knowledge to navigate the complex terrain of healthcare expenses effectively.

Description: Health is wealth, but much needed medical insurance for various needs is perceived solely for the wealthy and elusive to many. This webcast brings two highly regarded speakers in the health sphere to bust the myth that medical insurance is reserved for the wealthy and only covers known illnesses. The discussions will further dwell on products that are designed based on financial capability and customized needs while transgressing on risks and sustainability of creative products such as mental health.

Description: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: The Society of Actuaries Research Institute developed a new study to explore pharmacy financing. The goals of the SOA related to this research are to identify opportunities to increase transparency, encourage competition, align stakeholder incentives and mitigate increases in total cost of care. The research uses a value-based methodology.

Description: Risk adjustment (RA) is a key component for CMS Medicare Advantage program and California Medicaid Managed Care program. While both RA programs follow generally accepted basic principles at a high level, their underlying methodologies and assumptions are also quite different. Due to recent events such as COVID-19 Public Health Emergency and Medicaid redetermination delay and restart, it adds complexity to Risk Adjustment. This is a hot topic in the industry and has significant impact to health plans. Keeping current with risk adjustment program changes and understanding the commonalities and differences of these two government risk adjustment programs is important to our health actuaries. Compare these two risk adjustment programs so you can learn key elements of a risk adjustment program, similarities and differences in methodology and assumptions , as well as special considerations due to serving different populations.

Description: Misalignment in value-based care approaches between payers and market segments (Medicare, Medicaid, self-funded employer groups, and commercial insurance) creates significant headwinds and friction for health care providers seeking to succeed in an environment that is moving toward more value-based care models and payment approaches. However, while multi-payer approaches in value-based care are critical to eliminating these misalignments, uptake in such programs has been lagging for a variety of reasons. Hear about lessons learned from a selection of specific multi-payer initiatives to understand what went well and what challenges were encountered in expanding these initiatives more broadly. You should be able to walk away from this session with an appreciation of the potential for multi-payer approaches and the challenges faced in gaining traction with them.

Description: Paid Family and Medical Leave (PFML) benefits have expanded rapidly in recent years as an increasing number of states have required employers to provide these benefits to their employees. Examine recent developments in PFML benefits, for example, the presenters will provide information on which states are introducing or considering PFML programs, what types of benefits are provided, what types of data is available to monitor experience, and what challenges programs have encountered.

Description: Join our annual Health Section Breakfast open to all attendees. Network, discuss ideas, and hear about the latest Health Section plans and projects from the Section council's executive officers. Be informed about new initiatives, resources, and research from the Health Section. Become involved as we work together to sustain and create meaningful opportunities and advancements in the industry, for our populations, and for our profession.

Description: This webcast will walk through several statistical methods for imputing race and ethnicity from U.S. datasets, highlighting strengths and weaknesses and evaluating accuracy.