Description: This session will discuss the implications of a proposed federal catastrophic long-term care program, the WISH Act. The session will focus on the benefit to consumers, the financial soundness of the proposed program and the regulatory steps necessary to achieve the desired public/private insurance program goals. The session may also consider state based reform proposals.

Description: 2021 Life Meeting - Session 8A: Use of Electronic Health Records in the Assessment of Life and Health Risks 9.1.21 Recording

Description: This session will kick off the key National Association of Insurance Commissioners (NAIC) activities, with a primary focus on updates to principle-based reserve valuations and appointed actuary topics. The presenters will provide insights into the current set of activities and initiatives being considered by the NAIC Life Actuarial Task Force (LATF) and Life Risk-Based Capital Working Group, as well as activities being undertaken by American Academy of Actuaries committees and work groups.

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: Medicare and Medicaid finance more than half of American health care. Medicare and Medicaid are at the forefront of nearly every major change in U.S. health care payments, from DRGs in the 1980s to today’s value-based care. Listen to a conversation with Bruce Pyenson, FSA, MAAA, who recently completed six years as a Medicare Payment Advisory Commission (MedPAC) commissioner and Stacey Lampkin, FSA, MAAA, who recently completed six years as a Medicaid and CHIP Payment and Access Commission (MACPAC) commissioner. Hear about programs’ current challenges, what changes the ex-Commissioners anticipate over the next few years, and how these changes might impact Medicare and Medicaid managed care plans, and spillover into employer-sponsored and individual commercial insurance. By attending this session, you will be able to appreciate the role of Medicare and Medicaid as health care payment change agents and foresee future health care payment changes.

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: State Medicaid programs have broad flexibility to establish their own payment methodologies and rates for hospital services. Many states direct additional funding to populations, services, and hospitals where Medicaid comprises a disproportionate share of total business, or where there are other access concerns (e.g. rural providers). Actuaries can play a key role in determining where those additional funds would have the most benefit.

Description: Misalignment in value-based care approaches between payers and market segments (Medicare, Medicaid, self-funded employer groups, and commercial insurance) creates significant headwinds and friction for health care providers seeking to succeed in an environment that is moving toward more value-based care models and payment approaches. However, while multi-payer approaches in value-based care are critical to eliminating these misalignments, uptake in such programs has been lagging for a variety of reasons. Hear about lessons learned from a selection of specific multi-payer initiatives to understand what went well and what challenges were encountered in expanding these initiatives more broadly. You should be able to walk away from this session with an appreciation of the potential for multi-payer approaches and the challenges faced in gaining traction with them.

Description: Explore a general overview of the Medicare Advantage VBID hospice model, including program goal and a brief review of available information on plan participation in 2021 and 2022. Join us to learn how the program can support other elements related to health equity and address social determinants of health. You will be able to focus on how to improve quality of life and care using palliative, concurrent and/or transitional care and hospice services. Elevate your understanding with a summary of publicly available hospice experience data published by CMS, as well as a review of published research by the SOA and others related to hospice and end of life care. Finally, expect technical guidance regarding VBID model financial implications and proposed enhancements to the program as CMS transitions from the current model due to expire at end of 2024.

Description: Understand the role of food based interventions in health care. Learn the difference between produce prescription and medically tailored meals. Review new policies that will affect Medicare and Medicaid populations. Evaluate the possibility of health cost savings due to these interventions.