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Session 007: Medicare Part D Accruals: Modeling and Financial Considerations
Session 007: Medicare Part D Accruals: Modeling and Financial Considerations After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan ...- Authors: Samuel Bennett, Adrian L Clark, Jonathan Hendrickson
- Date: May 2019
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Financial Reporting & Accounting>Statutory accounting; Health & Disability>Health insurance
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Session 008: Best Practices in Risk-Based Contracts
Session 008: Best Practices in Risk-Based Contracts More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some ...- Authors: Traci Leigh Hughes, Daniel Santmyer, Joseph Dean Heintzelman , Michael Goran, Jennifer Leazzo
- Date: May 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Health care; Health & Disability>Health insurance
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Session 077: Medicaid Risk Adjustment: Understanding State Specific Design & Application for Effective Program Management
Session 077: Medicaid Risk Adjustment: Understanding State Specific Design & Application for Effective Program Management This session will explore the national landscape of state Medicaid ...- Authors: Zachary Aters, Suzanna-Grace Sayre
- Date: Jul 2019
- Competency: Results-Oriented Solutions
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models
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Session 091: Medicaid Margin Assumptions - Opening the Black Box
Session 091: Medicaid Margin Assumptions - Opening the Black Box In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) ...- Authors: Sabrina Gibson, Michelle L Raleigh, James Randolph Piekut, Jaredd Martin Keith Simons
- Date: May 2019
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability>Health insurance; Modeling & Statistical Methods>Forecasting
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Session 075: Small Group Strategies for non-ACA Products
Session 075: Small Group Strategies for non-ACA Products A review of strategies for non-ACA products for small employers including level-funded plans, association health plans (AHPs), and ...- Authors: Karan Rustagi, Thomas Joseph Garrity, Nicholas Calenti
- Date: Jul 2019
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability>Health insurance
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Session 115: Data-Driven Explorations in Healthcare Credibility
Session 115: Data-Driven Explorations in Healthcare Credibility This session will explore the various methods of determining the credibility levels that are given to various size employer groups ...- Authors: Bryan Wayne Kassing , Michelle Elsie Roark, Timothy James Ryan
- Date: May 2019
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability>Health insurance; Modeling & Statistical Methods>Credibility theory
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Session 014: Impact of Quality Improvement Activities on Medical Loss Ratio
Session 014: Impact of Quality Improvement Activities on Medical Loss Ratio Intended for actuaries interested in understanding more about the Medical Loss Ratio and the impact Quality Improving ...- Authors: Scott O'Neil Jones, Michael McLaughlin , Jean Bernardi , Rand Sean Gingery
- Date: May 2019
- Competency: External Forces & Industry Knowledge
- Topics: Financial Reporting & Accounting>Statutory accounting; Health & Disability>Health insurance
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Session 032: Seniors, Dental Coverage, and Overall Health
Session 032: Seniors, Dental Coverage, and Overall Health Dental care is an important component of everyone's health, and senior citizens are no exception. With no public dental coverage ...- Authors: Joanne E Fontana, Martha M Stubbs, Catherine Elizabeth Lewis
- Date: May 2019
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability>Health insurance; Public Policy
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Session 059: ACA Risk Adjustment Data Validation – It Matters! Learning from Year 1 and Beyond
Session 059: ACA Risk Adjustment Data Validation – It Matters! Learning from Year 1 and Beyond "The ACA RADV Program will begin to impact issuers’ risk transfers in the 2018 benefit year (BY) ...- Authors: Karena Weikel, Chia Yi Chin, Matthew Sauter, Alexander Mark Vojta
- Date: Jul 2019
- Competency: Strategic Insight and Integration
- Topics: Health & Disability>Health insurance
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Session 46 - Reserving 101 for Health Actuaries
Session 46 - Reserving 101 for Health Actuaries This session is targeted for new ASAs/FSAs or actuaries who are new to reserving. The session will be delivered in two parts. The first part is ...- Authors: Roger Schacht, Gregory Sgrosso, Zhe Li, Zachary B Lamers
- Date: Aug 2019
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Financial Reporting & Accounting>Generally Accepted Accounting Principles [GAAP]; Health & Disability>Health insurance