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

Description: States can make ACA markets more attractive by enforcing compliance. Unlike other state opportunities, it doesn't cost anything. Pennsylvania made the change this year.

Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge

Description: The Regulation and Taxation e-course covers the regulatory environment of life and annuity insurance in Taiwan.

Description: This is the SOA website page displaying the table of contents for Risk Management: The Current Financial Crisis, Lessons Learned and Future Implications series of essays.

Description: Overview of the papers presented at the Retirement Implications of Demographic and Family Change Symposium

Description: This session explores the far-reaching changes to how clinical data will be sourced, processed and consumed in many payer use cases including risk adjustment, quality measurement, care management, claims adjudication, prior authorizations, and other payer functions. Robust, interoperable data exchange is a prerequisite for value-based care. Clinical data will be increasingly accessible to augment administrative (claims) data via standardized Fast Health Interoperability Resources (FHIR, pronounced 'fire'), at a fraction of the cost of a accessing a traditional medical record and in real-time. On May 1, 2020, HHS issued a final rule implementing interoperability and the patient access provisions of the 21st Century Cures Act of 2016, although enforcement has been delayed into 2021 because of the COVID-19 pandemic. The new regulations promote, “HHS’s vision and strategy for achieving a health information ecosystem within which all individuals, their personal representatives, their health care providers, and their payers are able to send, receive, find, and use electronic health information in a manner that is appropriate, secure, timely, and reliable to support the health and wellness of individuals through informed, shared decision-making, as well as to support consumer choice of payers and providers.”Once enforcement begins, CMS and the Office of the National Coordinator for Health Information Technology (ONC), have the authority to mandate adoption of interoperability requirements, and also penalize payers and providers for non-compliance or the delay and withholding of data.This ‘digital transformation’ of the clinical data ecosystem has far-reaching implications for enabling technologies including Natural Language Processing (NLP) and entire segments of services and vendors. It will eliminate many departmental barriers, duplication and error sources for health plans and impact every department and the underlying economics of delivering and managing care.

Description: The National Association of Insurance Commissioners (NAIC) has developed the Group Capital Calculation (GCC) for U.S.-based insurance groups since late 2015. GCC is designed to provide a coherent analytical framework to show a panoramic, transparent view of the interconnectedness, business activities and underlying capital support for an insurance group. The last field testing was completed in May 2019. The final proposal was adopted in late 2020. The Federal Reserve Board (FSB) also recently updated the group capital standard to an aggregation method, which is similar to the NAIC GCC. The Insurance Capital Standard (ICS) is under the development by International Association of Insurance Supervisors (IAIS) for Internationally Active Insurance Groups (IAIGs). It has entered the five-monitoring period from January 2020 to monitor the performance of the ICS V2.0 and the IAIS will perform a comparability assessment of the ICS V2.0 with the Aggregation Method (e.g. NAIC GCC) during this period.