Description: Increasingly, actuaries need to collaborate and partner with clinicians in order to be successful in value-based care and population health initiatives. Gaining credibility with professionals from different backgrounds, training and sometimes different objectives can be a challenge. Gain perspectives from actuaries and clinicians to discuss how to collaborate and achieve stronger results and outcomes. By attending this session, you will be able to: • Identify common scenarios where actuaries and clinicians need to collaborate. • Understand perspectives on how to partner and communicate with clinicians. • Describe successful strategies that take into account improvement of financial and clinical outcomes. • Understand how actuaries can provide valuable data to drive results and demonstrate outcomes.

Description: In the time since the original proposal to move healthwriting companies from the blue blank to the orange blank, there have been several incremental updates to the blue blank by the NAIC Blanks Working Group to integrate portions of the orange blank into the blue blank. Meanwhile, the NAIC RBC Working Group has issued their proposal to change the health test for comment and appear to be moving forward with the proposal to revise the health test. This would obligate companies that write predominantly health business onto the orange blank rather than the blue blank, which they have historically used for reporting. Discover background of the revised health test, the incremental updates to the blue blank that have been implemented recently, additional incremental updates proposed for upcoming blue blanks, and the current status of the Health RBC Working Group proposal to revise the health test. Hear observations about companies that have opted to 'take the plunge' and move to the orange blank ahead of the revised health test as well as companies that have opted to remain on the blue blank and incrementally update as new requirements are integrated into the Blue blank. By attending the session, you will be able to: • Understand the context of the initiative to revise the NAIC health test. • Summarize the recent changes to the blue blank implemented by the Blanks Working Group that integrate portions of the orange blank into the blue blank. • Summarize the upcoming proposed changes to the blue blank by the Blanks Working Group that integrate additional portions of the orange blank into the blue blank. • Summarize the current status of the Health RBC Working Group proposal to revise the health test. • Provide industry perspective on companies that have opted to move to the orange blank ahead of the revised health test and companies that have opted to remain on the blue blank until the NAIC requires it.

Description: Address issues in value-based contract accounting from an actuarial perspective. In Medicare and ACA business, what issues does risk adjustment present to value-based contract accounting? In Medicare, what issues do Part D present in value-based contract accounting and what are possible solutions? What are the issues in the use of provider stop loss in value-based contract accounting? Are there issues in the timeliness of claims in value-based contract accounting? Are we giving providers enough information for them to manage their population? How do we deal with deficit accounts? What are the pros and cons of capitation, gainshare, and full risk in value-based accounting?

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: In the past months, as COVID-19 has forced the reduced activity in the U.S. economy there has been some very substantial, but varied effects on the U.S. healthcare system. There is a lot of potential for confusion amongst providers and patients with regards to decisions related to which services ought to be rendered and which ought to be deferred. Two specific agencies – the Centers for Medicare and Medicaid Services (CMS), and the American College of Surgeons (ACS) have put together some guidance to add more clarity towards what types of services should be provided and what types ought to be deferred. In addition, this paper includes a discussion on what types of services are most likely to be deferred, and which ones will accrue pent-up demand to be released when many of the deferred services become available again.

Description: The SOA has translated four of its AIT report summaries into both Traditional and Simplified Chinese. They are “Behavioral Science”, “Big Data and the Future Actuary”, “Cancer Genomics”, and “Cloud Computing and Machine Learning Uses in the Actuarial Profession.

Description: This Society of Actuaries, working with LIMRA, Oliver Wyman and the American Council of Life Insurers, is releasing a series of pulse surveys aimed at obtaining a quick read on how the COVID-19 pandemic is impacting insurance companies and reinsurers.

Description: You will be reminded how to spot and avoid statistical biases and fallacies that are common to health care actuarial data and problems. We plan to explain various statistical biases and fallacies and for each show one or two examples of how they might pop up in healthcare data and what strategies can be used to avoid/account for them. Likely topics include simpson's paradox, regression to the mean, base rate fallacy, sampling bias, survivor bias, Berkson's fallacy, and others.

Description: Health care cost trends are a key ingredient that health care actuaries use in their practice. In collaboration with the Health Care Cost Institute (HCCI), the Society of Actuaries has put together a data extract for practicing health actuaries to be able to better understand historical trends and cost disruptors.

Description: A diverse panel of health actuaries will be available to answer any attendee questions. An ACA question, we have it covered! A valuation question, we will find a solution. A professionalism issue, we will make a ruling! A regulatory concern, we will help guide the way!! No question is off limits! There are no stupid questions!