Description: Many drugs, like the immunologic drugs used to treat inflammatory and oncologic conditions, are FDA-authorized to treat more than one condition. Given different conditions have varying clinical outcomes and costs, it is likely the same drug provides a range of value across multiple conditions. However, such drugs have traditionally had a single list price and corresponding payer net cost. Indication-based pricing and benefit design (IBPBD) is intended to address the variable clinical and economic value for the same drug across multiple treatment indications. As this trend continues to evolve, the determination of drug value by treatment indication will create risks and/or opportunities in pharmacy benefit design, ultimately impacting pharmacy PMPM forecasting and incurred costs. Learn from faculty as they: Provide the business context for IBPBD. Describe varying structural approaches. Discuss the market conditions that can motivate or demotivate payers. Explore operational barriers. Recommend a role for actuaries. To bring the discussion to life, a case study will be reviewed. By attending the session, you will be able to: • Describe the meaning of Indication-Based Drug Pricing and Benefit Design (IDPBD). • Understand the risks and opportunities with IBPBD. • Articulate the advantages and disadvantages of distinguishing the value of a drug by treatment indications.

Description: Medicare and Medicaid finance more than half of American health care. Medicare and Medicaid are at the forefront of nearly every major change in U.S. health care payments, from DRGs in the 1980s to today’s value-based care. Listen to a conversation with Bruce Pyenson, FSA, MAAA, who recently completed six years as a Medicare Payment Advisory Commission (MedPAC) commissioner and Stacey Lampkin, FSA, MAAA, who recently completed six years as a Medicaid and CHIP Payment and Access Commission (MACPAC) commissioner. Hear about programs’ current challenges, what changes the ex-Commissioners anticipate over the next few years, and how these changes might impact Medicare and Medicaid managed care plans, and spillover into employer-sponsored and individual commercial insurance. By attending this session, you will be able to appreciate the role of Medicare and Medicaid as health care payment change agents and foresee future health care payment changes.

Description: Find out more about the inforce product rate management process for health and LTC products. Requirements can vary by state, by issue era, and by product type and in some cases require filings to certify compliance on a regular basis. Discover recent trends in inforce rate management in the industry, including any changes seen coinciding with COVID-19 and its impacts to the regulators. By attending this session, you will be able to: • Describe or perform an inforce rate management for health products. • Understand the applicable state regulations. • Be informed of current industry trends for this work.

Description: Market researchers use cluster analysis to segment groups for targeted messaging. Law enforcement uses cluster analysis to identify high need neighborhoods to allocate resources effectively. Educators use cluster analysis to adapt their teaching methods to a particular group of students. More and more, health actuaries are using cluster analysis in their day-to-day work. Understand the basics of cluster analysis and potential applications through this session. By attending this session, you will be able to: • Describe the basic types of cluster analysis. • Explain health applications of cluster analysis. • Identify sources of additional information.

Description: The COVID-19 pandemic has had an impact on all aspects of daily life and its impact extends to how disability incidence may play out in the future. Product profitability will be shaped by how morbidity patterns, interest rate levels and other key drivers will play out into the future. In this session, our panel will discuss COVID’s impact on IDI morbidity experience as observed over the past 18 months, offer comparisons and insights in light of other insurance lines of business, and share emerging information on the on-going effects of Long COVID. Highlights will also include how regional differences and implications for insurers as the industry moves further into the COVID vaccine era.

Description: Reunite with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, IFRS 17, product strategy, cross-border communication and discussion, and more. Advance your career through learning and networking opportunities, and share your experiences in the finance and insurance industries, as well as other fields related to actuarial science.

Description: Read about the A Model of the Impact of Social Distancing on the Transmission Rate of a Communicable Virus.

Description: Since the outbreak began in January, numerous research groups throughout the world have developed models to forecast the number of deaths that could result from COVID-19.

Description: This report provides highlights of a weekly survey of practices regarding the mitigation of the spread of COVID-19 in the U.S. during the second half of January 2021 along with comparisons to prior half-month time periods. The survey asks about the degree to which the respondents perceive that people in their community are following 21 common mitigation practices. The responses are separated by state and compared to state level statistics regarding the level of COVID-19 infections from the Johns Hopkins COVID database for the same time period.

Description: This is a review of the publication entitled 'Medicare: Health Insurance for the Aged, 1969: Geographic Indices of Reimbursement by State and County.' It is of value to health actuaries because it contains information as to the variation in health insurance claim costs by geographical areas within the United States.