Description: Renal disease is a very heterogenous medical condition whose end state is dialysis, a recurring cost intensive medical condition. Dialysis cost is one of the major medical cost drivers in USA. Insufficient and improper care management in the early stages of CKD (chronic kidney disease) leads to early incidence of end stage renal disease (ESRD) among CKD patients which not only leads to high medical costs, but also reflects poor health quality.

Description: "Most patients enter the health care system through their primary care provider or through the Emergency Room or an Urgent Care Center. How an emergency room is structured, managed, and provides care is one of the major forces impacting the total cost of care. Yet it is often an after-thought and ignored by both health plans and health systems. In reality, the structured introduction of efficient practices can substantially reduce the quantity and cost of health care services. Further explore useful information to better understand and see how there are still substantial opportunities for improvement."

Description: To inform and educate stakeholders for health plans and insurers on novel ways to optimize reinsurance structures to meet capital related goals and boost RBC and liquidity ratios. In lieu of traditional market-based financial instruments involving equity and/or debt, a quota share transaction can be used with potentially far more attractive terms and achieving essentially the same result.

Description: Milliman was engaged by the SOA to conduct two Accelerated Underwriting (AU) surveys, one of direct companies and another of reinsurers. The surveys explored actual results from 2019–2021 and expected results from 2022.

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: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: "Examine the exciting possibilities for artificial intelligence (AI) in health care and its potential to transform the patient journey. You will learn about the various touchpoints where AI is being applied along the patient/care journey, including provider search tools, claims analysis, and fraud detection. By attending the session, you will be able to: Have a comprehensive understanding of the opportunities and challenges presented by AI in health care Evaluate the potential impact of AI on their own organizations Be equipped with strategies for effectively implementing AI solutions and maximizing their benefits for patients, providers, and payers"

Description: The momentum towards value-based care has increased focus on how payers attribute accountability for the cost and quality of member care to providers. The current landscape has a myriad of methodologies and accountable parties. Examine the ideal future state of attribution discussing trade-offs in goals (e.g., population coverage vs. member influence), accountable parties (e.g., should third-party vendors be involved?), and methodologies.

Description: What is the value of the health care we pay for? As medical inflation continues to outpace general inflation, this question is more important than ever. As actuaries, we are often called upon to evaluate the value of medical care. Are the ways the value equation is commonly constructed reflective of our aspirations as a society? What gravitational forces do we need to be aware of that perpetuate the status quo, mental biases and methodological pitfalls and how do we actively work to correct for them?

Description: There exists profound health and access disparities among people from different demographics and socioeconomic backgrounds. Health equity is now a central policy directive for the U.S. government and CMS. Speakers representing policy, health care delivery and actuarial spaces will help you discover what health equity policy directions may look like, the challenges health care providers are facing and how actuaries can contribute to the effort in bridging the health equity divides.