Description: Similar to how states had made adjustments to their capitation rates to reflect acuity adjustments caused by the onset of the pandemic, states will need to modify the rates to reflect the unwinding since utilization patterns and average acuity per enrolled member will change. When the continuous coverage requirements set forth by the COVID-19 Public Health Emergency (PHE) ended, Medicaid-managed care programs across the country adopted various approaches to phasing out maintenance of effort (MOE) as a result of changes to the PHE-era continuous eligibility requirements. Phasing out the MOE requirement will ultimately result in members who no longer meet eligibility requirements losing their Medicaid coverage. Further, states are facing a wide variety of circumstances and are implementing diverse approaches to the MOE phase-out. This topic will be of significant interest to all actuaries and stakeholders of the capitation rate development process for Medicaid-managed care programs. Join us as we discuss the operationalization of the PHE unwind while referencing the SOA's research project which models the effects of the unwinding on Medicaid eligibility and population costs. You will learn about the various approaches that different states have adopted to manage the unwinding process, which will be instrumental for accurately pricing managed care rates.

Description: High inflation rates can affect disability insurance in a variety of ways. Learn about rising price and wage inflation trends and why they are of interest to disability insurers. You will also hear presenters address topics such as recessionary pressures, the eroding value of benefits, wage growth, top-line trends and expense pressures. By attending the session, you will gain insight into how inflation should be considered in pricing, reserving and financial modeling.

Description: Dive into a summary focused on the discussion from the Health Section's Pharmacy Partnership Forum in March 2023 entitled 'Reimagining Pharmacy Financing' where a multi-disciplinary group of clinicians, health economists, academics, and actuaries met and discussed the following questions: - How do we define the value of prescription drugs? - How do we measure the value of prescription drugs? - How do we scalably and meaningfully apply the answers?

Description: In this webcast, the presenter will cover mental health in insurance products. Learn about the public’s increased interest in mental health and the ways insurers can meet this demand, how we can embed such offerings in insurance and how to successfully expand mental health coverage to those in need. The second speaker will cover how cancer and the simplified issue insurance market has evolved in Korea. In this session, the speaker will share the ease of selling / onboarding, thus allowing a greater penetration of products.

Description: El webcast presentará una comparación de alto nivel de los acuerdos internacionales de financiamiento de la atención de la salud y proporcionará una comparación y contrato con los modelos de Colombia y otros modelos latinoamericanos.

Description: How well can we predict ACA HHS Risk Adjustment Data Validation (HRADV) results? Put another way, how susceptible is the current HRADV process to small sample volatility? What potential remedies are there to the current model's shortcomings? Every plan, regardless of how many members they have above the 1000 minimum, count equally if they qualify for an HRADV with how the result is interpreted, and the subsequent HRADV risk transfer ($330M in 2023).

Description: A panel of leading reinsurance executives will provide an overview of the health reinsurance market that explores existing reinsurance transactions reported under Schedule S, large claim research drawing insight from the latest five-year Merative Commercial MarketScan Research Database, stop-loss reinsurance options for Accountable Care Organizations (ACOs), and other reinsurance applications being seen in the market.

Description: A panel of leading reinsurance executives provide perspective on topics to include cell and gene therapy, structured reinsurance, reinsurance demand for value based care arrangements, and how reinsurers view a variety of risk transfer opportunities.

Description: This session will discuss what is meant by 'bias' and 'fairness', the regulatory environment, how to identify and mitigate bias in models, and proper oversight and governance of model building. The session will include a case study.

Description: Cover a variety of topics centered around the unsupervised learning technique called 'clustering'. The presenters will take you through a wide array of topics that range from 'What is Clustering?' to 'How can I use this technique to solve problems I didn't even know existed?' In the health care industry, everyone is looking for an edge in reducing total spend-cluster analysis finds the unambiguous in an ambiguous framework of results.