Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: The key tasks of credit risk capital project under CROSS II mainly focus onL(1 )Adjustment of measurement framework; (2) Calibration of risk factors, including both credit spread risk and credit default risk;3)Introduction of concentration risk measurement; (4) Higher requirement on look-through rule.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: More and more providers are desiring risk-based contracts instead of traditional FFS-based contracts. This session is intended to outline some of the actuarial best practices in risk-based contracting related to the many flavors of the CMS ACO programs, as well as Commercial risk-based contracts.

Description: Artificial intelligence (AI) and Machine Learning (ML) are accelerating us into the fourth industrial revolution. In the next few years technological change and innovation will be rapid. The implications of AI on the actuarial profession are real and game changing. This session will help health actuaries understand what to expect from AI, how to begin using AI, and how AI will dramatically enhance the actuarial profession in the near future.

Description: Court is in session and you are the jury! Follow along as challenging aspects of actuarial professionalism are explored in a court-like setting. Deliberate based on what you already know from your own experience as well as based on what you learn in this session and then deliver your verdict accordingly. Who says learning about actuarial professionalism can't also be fun?

Description: This session will cover the latest developments of the Medicaid Final Rule proposed changes and their implications going forward.

Description: This 1997 presentation from the 32nd Actuarial Research Conference develops a stochastic generator for the generation of scenarios of the S&P 500 index, dividend yield, consumer price index, and U.S. Treasury yields. The authors first create a set of 'stylized facts' for these series. They estimate statistical models for these series. These in-sample statistical models are themselves not suitable for generation of scenarios for decision making, but instead are additional 'stylized facts' that assist in model development. The 'best' statistical model according to standard statistical model selection criteria can easily lead to a model that is highly unsuitable for generation of scenarios for decision making. The authors develop a stochastic generator that is suitable for decision making under uncertainty.

Description: This 1997 presentation from the 32nd Actuarial Research Conference provides background on the work of the Society of Actuaries' Research Effectiveness Task Force [RETF] and presents the current status of that work in order to set the stage for breakout sessions during which Conference attendees have an opportunity to provide input to the SOA research effectiveness review.

Description: This presentation from the 1998 Actuarial Research Conference is about about retirement plans in the late 1990's. From Actuarial Research Clearing House 1999, Vol. 1.