Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: Telehealth came to the forefront in a significant way during – 2020–2021, partially due to the pandemic. What is the reasonable expectation of future consumer use of telehealth? This virtual option has the ongoing potential to increase access to health care services to plausibly lower the cost of care. Furthermore, telehealth continues to evolve as a technology. Keeping current with advancements as well as consumer willingness to use this medium are important to the future of health insurance. By attending this session, you will learn about the latest advancements in telehealth as well as implications for cost of care due to consumer use.

Description: It’s well documented that oral health is correlated with overall health. An exciting array of new dental technologies is emerging, from virtual reality through AI to CRISPR. These ground-breaking advancements have the potential to revolutionize dentistry.

Description: Informal caregiving is a major source of long-term care (LTC) and long-term supports and services (LTSS) more broadly. The benefit of informal caregiving is appreciated by those receiving it, and most caregivers find purpose in their work. The costs of caregiving fall on employers, other family members, the health care service sector, stakeholders in the LTSS system, and most importantly the caregivers themselves. Providing support to these caregivers can therefore benefit employers, employees, and their families, as well as the many payors of formal LTSS. Hear from three experts in caregiving who will provide their perspective about how to support information caregivers — operationally and financially — to help them succeed in their purpose. Understand benefits this support can have to the other stakeholders in today’s LTSS system. By attending this session, you will be able to: • Explain the importance of informal caregivers to stakeholders in the LTSS system, including the impact to payors and employers. • Describe the challenges informal caregivers face, and paths to success and avoiding burnout. • Discuss potential future financial solutions that may benefit caregivers, including employee programs and insurance opportunities.

Description: Review of non public options to finance care including personal savings, revers mortgages, family care and private insurance.

Description: Guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting.

Description: Following recent SOA Research, we look at how climate scenarios will affect Long Term Care assumptions and business.

Description: On February 15, 2022, the Association Forum Health Care Collaborative, a collection of metropolitan Chicago based Healthcare associations, held its winter event. This virtual gathering featured two sessions titled: “Healthcare Policy Perspective” and “Megatrends and Tipping Points that will Define Success in the "New Normal".

Description: This study would assess the impact of recent patient care innovation(s) on health care and the health insurance industry.

Description: Family caregivers are a critical link in providing long-term services and supports (LTSS), but they have significant unmet needs. To better support family caregivers, Congress authorized the Recognize, Assist, Include, Support, & Engage (RAISE) Family Caregivers Act in 2018 and created the RAISE Family Caregiving Advisory Council. The Council identified recommendations to serve as the backbone of a national strategy to improve the physical, emotional and financial well-being of family caregivers. A new report, "Asking Directions: Mapping a Course to Support Family Caregivers," identifies specific actions across a variety of players for meeting the Council’s recommendations. It summarizes insights from a year’s worth of strategy sessions and interviews with representatives of over 100 organizations. The report brings together thoughts on best practices and the most critical action steps from national and state organizations, county health providers, the direct care workforce, large and small employers, aging and disability organizations, faith-based groups, respite care providers and more. This article summarizes the research methods and key findings of the report and the work conducted by the Leading Age LTSS Center @UMass Boston and Community Catalyst’s Center for Consumer Engagement in Health Innovation.