Description: This session reviews the importance of using benchmarks in healthcare utilization management to improve organizational and patient outcomes and increase efficiency. It highlights how benchmarks can inform decisions about utilization management strategies and benefit members, payers, and providers. The presentation includes best practices, successful examples, and solutions to challenges, focusing on claim utilization, risk adjustment efficiency, quality metrics, and overall performance. Additionally, insights into the future of benchmarks and the value of analyzing the entire distribution of data for deeper insights will be shared.

Description: The overarching objective of this research project is to explore the connections between mental health and mortality, as well as the influential factors present during the various phases of this continuum. The project analyzes SAMHSA mental health treatment data and BRFSS survey response data, as evidence for change in the approach to mental health services and insurer underwriting. For life insurers, more complete data on SDOH, lifestyle habits/behaviors, and mental health diagnoses may help with the identification of the appropriate insurance product. Having details on diagnosis and clear treatment history may make the difference between denial of coverage and offering a different insurance policy/plan (term or reduced term policy instead of whole life).

Description: In this presentation, actuaries and data scientists from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning. Presented with a unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their model development to the cloud and delivered a product in less than a week through a unique virtual engagement.

Description: The webcast addresses the four stages of effective leadership, and the three main drivers of effective leadership. It provides several metrics for assessment. Use of these ideas allows any leader in a leader-subordinate situation to raise the level of the subordinate to mastery level. The material in the discussion is based on an article in Stepping Stones (Sep 2023), "Are you an Empowering Leader", by Russell Jay Hendel.

Description: CMS has pioneered innovative strategies for Medicare and Medicaid to address Social Determinants of Health (SDOH). Employers can learn from these models to implement similar approaches for their employee populations. Learn how employers can understand and address SDOH, the incentives for doing so, and the broader benefits.

Description: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

Description: In discussing the contemporary reactions to this regulation, as well as how EU-based insurance firms adapted to the shift, this segment will invite us to question our assumptions on the role of gender-based pricing in the future of the industry. In the latter half of the presentation, we will delve into the challenges faced by LGBTQ+ individuals when accessing life, health, and auto insurance.

Description: This interactive webcast uses case studies and a new framework to show how retirement plans and practices can be fitted to best serve organizations’ missions and objectives, guided by data and analytics measuring their workforce impact.

Description: Short Form Professional Development Videos - Stat vs. economic frameworks  Recording

Description: Challenges of Provider Reimbursement