Description: Join a panel of experienced Health Actuaries as they discuss the significance of actuaries' contributions to making U.S. health care better and how actuaries might enhance their contributions to fixing problems.

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: 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: Experience a comprehensive overview of the current purchasing landscape for health care services, with a specific focus on how healthtech start-ups can break into the employer-sponsored health care market. You will learn about the key players in the healthcare industry, as well as challenges that new entrants (+ B2B vendors more generally) face in selling their services to employers and health plans.

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: Investigate Deloitte's methodology to quantify the cost of health inequities attributable to racial bias, gender/sex bias and socioeconomic bias. We will illustrate the methodology by calculating total potential cost savings across different disease states and discuss both the role that actuaries play in addressing health inequity and the steps that organizations can take to activate health equity.

Description: Come explore an in-depth overview of telehealth to set context and navigate the continuing expansion of telehealth and its integration into the healthcare delivery system. You will examine the forces that shape telehealth offerings and expect a view of the possible futures of this evolving modality.

Description: With the mandated health plan transparency files, health plans and providers are now able to substantially enhance their provider contracting efforts. Although the files are large and cumbersome they are market disruptors and provide new insights for provider contracting efforts. Explore a demonstration on the type of information now available and how it can be used to enhance this from both a health plan and health care provider perspective.

Description: Health equity is taking a front row focus in many health arenas. Take a closer look at some of the efforts being used to ensure health equity. One area of interest to actuaries is value-based insurance designs (VBID). VBID can be incorporated into exchange plans. These innovations to prevent and treat disease have led to reductions in morbidity and mortality. Learn techniques to improve the quality of care and reduce barriers to high-value care in the form of high-cost sharing.

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."