Description: Presentation for Session 57.

Description: The modern valuation manual steps up the need for actuaries to know and apply statistics. If your recall of common actuarial statistical techniques is more than one standard deviation below the mean, this session will provide the lift you need.

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.