Description: 2021 ImpACT Conference - Session 13E: Managing Cognitive Bias in ERM Processes 10.29.21 Recording

Description: "Direct medical costs for cancer care topped $209 billion nationally in 2020, accounting for a significant proportion of all health care expenditures in the U.S. Indirect costs are also significant, encompassing loss of productivity, wages, leisure time and decreased quality of life. The way cancer programs deliver and are reimbursed for care is rapidly changing. As the cost of cancer care continues to rise, several new value-based care programs - both public and private - have attempted to curb these rising costs. Learn about the current landscape of VBC oncology programs, several key challenges and opportunities with oncology analytics, as well as anticipated evolution of cancer care in the near future. Topics include: Current VBC oncology landscape, including a more detailed discussion on CMS' latest oncology program, Enhancing Oncology Model (EOM) Discussion on current challenges and opportunities with oncology analytics, including some advanced methodologies that have been developed based on documented clinical pathways to better understand cost drivers Future state of oncology care including emerging pharmaceuticals and novel therapies, personalized care regimens, and other clinical innovations"

Description: Actuaries are increasingly being asked to incorporate Economic Scenario Generators into their work. Whether it be a Risk Neutral model for pricing or a Real-World version for Economic Capital modelling, using these tools can help produce a much more robust analysis. Unfortunately, these models and their underpinnings are also very complicated, which can lead to confusion. The presenters in this session will try to demystify some of this. In particular, they will address the following questions: • What is the difference between Real-World and Risk Neutral scenarios? • When should I use one or the other? • How are these models calibrated? • What are some of the misconceptions about these models?

Description: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: This session will present results of the most recent SOA/LIMRA studies of variable and fixed-indexed annuity policyholder behavior including withdrawal behavior, guaranteed living benefit elections and surrender activity. Conducted annually since 2006, a discussion on the results of these studies show how they have changed over time, as well as areas where the analysis will need to change or expand. After that, the presenters will focus on dynamic lapse for hot money businesses, which is an important topic for fixed deferred annuity. Key takeaways from this area will include an understanding how to differentiate between hot money and warm money, the different formulas used in the industry, and how to adjust an asset portfolio to protect against the risks associated with hot money businesses.

Description: "Examine the impact of traditional deductibles on health care equity and the need for innovative plan designs. You will learn about the limitations of consumer-driven health care costs broadly today, as well as alternative cost-sharing approaches that have been successful in driving consumerism without exposing members to high costs. By attending the session, you will be able to: Have a clearer understanding of the issues surrounding deductibles Be equipped with practical ideas for creating more equitable and effective cost-sharing solutions Assess the feasibility and potential impact of implementing these solutions for your own organization"

Description: Explore cutting-edge advancements in virtual care, including remote patient monitoring and care delivery in the metaverse, which build on the foundation that pandemic-era telehealth built. Gain a deep understanding of how these innovations are set to shape the future of telehealth and healthcare more broadly. By attending the session, you will be equipped with a roadmap of the key trends and opportunities in virtual care, and be able to identify potential challenges and solutions for their own organizations in leveraging these new tools.

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: Delve into the factors contributing to the rapid growth of high-cost medical treatments and how payers can manage the financial exposure that comes with them. Learn about the current and near-future state of million-dollar medical costs, as well as the trends shaping the industry. By attending the session, you will have a better understanding of the underlying drivers of high-cost treatments and will be equipped with practical strategies for mitigating their financial impact, including risk management techniques, cost containment measures, and new payment models. Additionally, you will be able to identify key considerations for implementing these strategies in their own organizations.

Description: Ensuring employees retire with adequate benefits is an ever-growing challenge. During this webcast, we will highlight key insights from the fields of behavioral economics and data analytics that can be utilized to better equip employees for retirement. Areas of focus will include inherent biases that people exhibit and how employers can use these biases to design plan features that will nudge their employees towards making better decisions for their futures.