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: 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: Learn about the innovations of life and health products around the world. Expect to focus on: 1. Product development and pricing innovation in APAC region. 2. The Insurtech ecosystem creating new products by applying new technology and distribution channels in Latin America and Europe. 3. Products designed to supplement public sector offerings to close health protection gaps for underserved communities in the Middle East Africa and Asia Pacific region.

Description: Explore historical trends in enrollment, carrier participation, and competition over the first 10 years of the individual marketplace as a basis to frame what the future could hold for the next 10 years. Draw parallels to other lines of business (e.g., Medicare Advantage, employer group) as we look at how the market may evolve and the capabilities required to succeed. This session would be valuable for anyone interested in consumer purchasing behavior, quality and risk adjustment, employer benefits, provider dynamics, and the individual market more broadly. By attending this this session, you will be able to articulate the impact of recent legislation and regulatory actions on the Individual market, including subsidies, employer funding vehicles (e.g., ICHRA), distribution channels, and product requirements.

Description: As more gene and cell therapies enter the market at increasingly higher price points, they are ushering in a new era of medicine for rare diseases. Unlike most traditional therapies, gene and cell therapies typically have a short or one-time treatment administration and are anticipated to provide long-term clinical benefits. Actuaries must be prepared to assess, manage, and/or mitigate the risks associated with these therapies. This session includes three different perspectives—a regional plan, a stop loss/reinsurance carrier, and a health care consultant.

Description: Investigate the importance of collaboration with accounting, underwriting, sales, marketing and other professions as an actuary when you attend this webcast. Cross-functional positions can cause unique challenges to arise, like various experts attempting to balance growth and profitability. Discover an opportunity to learn about relevant ASOPs and dive deeper into contemporary examples that highlight specific professionalism issues that can develop.

Description: Develop a better understanding of specialty drug trends and their increasing healthcare costs for more than the past decade by attending this webcast. With the introduction of price competition, you will see changes in the market for biosimilar products and patent-protected drugs. For example, the drug Humira will be gaining 10 biosimilar competitors in 2023. Alone, Humira can represent over 20% of total pharmacy spend for health plans. Join us and discover how price competition is a turning point for the pharmaceutical industry and will define its direction for the next decade.

Description: The editor of Health Watch previews the articles in this issue.

Description: Overview of public health (responsibilities, funding, challenges) and discussion of the role actuaries can play in achieving population health goals.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.