Description: Derek Ray shares his excitement on serving as Chair of the Health Section Council in 2024, including recent section achievements, upcoming activities and a call to action for volunteers to contribute their expertise to the SOA.

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: 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: This is a transcript of a 1982 meeting of the Health Section. Includes presentation and discussion of three papers: a. Cumulative Anti-selection Theory by William F. Bluhm b. Regulatory Monitoring of Individual Health Insurance Policy Experience by John B. Cummings c. Medical Care and Services in Canada by Frank G. Reynolds From Record Vol. 8, No. 4

Description: Subtitle: My real-life connection to (almost) every supplemental product Data is king, but maybe it should be dethroned once in a while so we can better understand the "why" behind the data.

Description: Panelists address topics such as techniques for testing data quality, the actuary’s responsibility for verifying the reasonableness of data, and considerations in modifying data sources for specific situations. Included is a discussion of ASOP No. 23. From the Record of the Society of Actuaries, Volume 27, No. 1, Session 96

Description: Dive into the challenges of practitioners working across components that make up the Risk Management infrastructure with a variety of health, life and P&C insurers in this panel discussion webcast. Panelists will highlight how these insurers operate with the data and tools available to them and the existing challenges in interactions with an organization's leadership. Be part of this webcast that delves into the interplay between first- and second-line defense and how high levels of independence and professionalism can be achieved in a fast-moving, multi-discipline cross functional ERM role.

Description: The article provides insights about the need for revolutionary actuaries in Saudi Arabia due to the reform that is happening across the kingdom under all sectors. Then I talk briefly about the health sector and the transformation that is happing in the sector, and how qualified health actuaries can contribute to this health reform.

Description: This excerpt is from a presentation done by a panelist at the Intercompany Long-Term Care Insurance Conference Association closing session in Chicago in March. We can never fully express our thanks to the Alzheimer’s Association and Tom Doyle for the courage to share his moving story and optimism for the future.