Description: "Most patients enter the health care system through their primary care provider or through the Emergency Room or an Urgent Care Center. How an emergency room is structured, managed, and provides care is one of the major forces impacting the total cost of care. Yet it is often an after-thought and ignored by both health plans and health systems. In reality, the structured introduction of efficient practices can substantially reduce the quantity and cost of health care services. Further explore useful information to better understand and see how there are still substantial opportunities for improvement."

Description: The introduction and effective application of US GAAP LDTI have increased the scrutiny of those reviewing the updated financial results. That is because LDTI has resulted in significant changes in actuarial reserving and deferred acquisition cost (DAC) models for long-duration contracts, including significant changes to data, assumptions and required disclosures. In light of the changes, greater reliance has been put on companies’ model risk management (MRM) teams and model validations to assess the conceptual soundness and accuracy of their companies’ actuarial models and to assess that the underlying data and process utilized are suitable and appropriate. This article covers a brief background on model validation, walk through a sample LDTI-focused model validation framework/test plan, then provide insights on common LDTI-related validation observations based on the authors' prior validation experience.

Description: Broaden your understanding of how long-term care (LTC) is provided and brainstorm with other actuaries on ways to help society fund future LTC solutions. How we fund and provide LTC for our loved ones has changed over time and will evolve still by the time we retire. In this session we will explore the variety of ways that we fund LTC services: out of pocket and with informal care, Medicaid, lifeplan communities (Continuing Care Retirement Communities and and the Continuing Care at Home model), private LTC insurance and more. You will leave the session appreciating that providing long-term care is a key feature of our aging society and understand the variety of ways that we fund LTC today and may in the future.

Description: "Hear AM Best rating analysts discuss the rating process and the best capital adequacy ratio (BCAR), a quantitative foundation for AM Best’s assessment of carriers’ financial strength. The benchmarking of BCAR scores for various company types (national MCOs, BCBS plans, smaller regional plans) will be discussed. Look at how changes in investment and underwriting environment impacted the results over the past several years. Further, AM Best’s view of the quality of capital and various factors impacting the overall assessment of the balance sheet strength will be discussed. By attending this session, you will: Gain an understanding of AM Best’s building block approach to ratings and how the BCAR results fit into the process. Learn the differences between RBC and BCAR models. Learn how various factors—e.g. liquidity, financial flexibility, financial leverage, the org structure—impact the final AM Best assessment of health companies' capital."

Description: Risk management techniques do not include system science. System science requires that the uncertainty of the world is incorporated into the results. The articles explains the difference between risk and uncertainty. Learn how risk practices create an overoptimistic view of future outcomes.