Description: The June 2021 Supreme Court ruling in California vs. Texas has significant ramifications on Affordable Care Act markets. This session will provide the actuarial community an overview of the ruling, the likely impact on health insurance markets, and potential legislation to address the ruling details.

Description: Help consumers understand their rights in health care and understand how technology is embedded into the health care industry. On top of that, you will also hear about topics related to professionalism. During this webcast, you will learn about: ▪ An overview of the health insurance market ▪ Health care provider billing and contracting ▪ Recent trends with insurers and health care providers ▪ Identify areas of excessive billing and fraud ▪ The impacts of technology on billing practices ▪ An understanding pharmacy benefits, including discounts and rebates

Description: This session will discuss: • What is social insurance and advantages of financing LTSS that way • Design decision points for an LTSS program • Existing examples of programs in the US and Abroad • Challenges and differences in pricing state-based LTSS financial reform.

Description: "During the pandemic there has been provider burn out, early retirement, hospital consolidation, and lack of staff in step down facilities. It is taking longer to get appointments. Take a look at the impacts of this andat how this can affect quality ratings in Medicare. You can also explore meeting quality incentives in Medicaid and how the current requirements for these plan to say they have adequate networks. Will the provider shortage have an effect upon actuarial rate certifications? If so, how? Are there any forecasts for how long this shortage will last? What are the impacts to care giving to the Seniors and Medicaid beneficiaries as well as plan design changes? Those who are intermediate level Medicaid and Medicare actuaries are encouraged to attend. By attending this session, you will be able to: Have a good understanding of the current Medicare and Medicaid situation and its impacts Understand strategic ideas of how to keep quality of care and access to care available"

Description: Explore the findings from the research paper recently released by Milliman and the SOA, highlighting the growing need for support of informal/family caregivers. We will discuss both quantitative and qualitative data that illustrates not only the cost and burgeoning need, but the mental/emotional stressors that come along with this work.

Description: As we entered 2014, actuaries became familiar with three risk stabilizing mechanisms in the early years of the ACA marketplaces, colloquially known as 'the 3Rs'. As we enter 2024, there is renewed focus on rating compliance and risk adjustment. Speakers will highlight pricing considerations when determining cost-sharing reduction premium loads as well as related issues pertaining to risk adjustment and metal tier pricing.

Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: 2021 ImpACT Conference - Session 1B: Mental Health Care in a Virtual World 10.25.21 Recording

Description: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.