Description: On average, contracts receiving their first star rating receive 3.20 stars, compared to existing or established contracts receiving 3.90 stars on average. This 0.70 disparity in quality ratings creates significant hardship on new contracts when this lower star rating decreases their payments in the following calendar year. This article explores the disparity in Medicare Advantage Star Ratings between contracts receiving their first star ratings (“New” contracts) and existing contracts, including: 1. Understanding what happens to Medicare Advantage Payments when contracts receive lower star ratings? – What is the Star Rating cliff and why does it matter to new contracts? 2. Explaining when a contract receives their first star rating and how much enrollment this requires – When does the Star Rating cliff occur? 3. Noting which specific star measures “New” contracts struggle with, including those contracts under large parent organizations, contracts with rapid growth, and all other new contracts. – How can my contract avoid the Star Rating cliff?

Description: What is the difference between a Single-Payer and Universal Health Care System, and how could the U.S. implement a system that would reduce the growth of medical costs while increasing quality.

Description: Read the November 26 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Read the February 2020 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: The Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

Description: Join us for an insightful webcast as we delve into the far-reaching implications of the recent Supreme Court decision to overturn Chevron deference. This landmark ruling, which previously granted federal agencies significant leeway in interpreting ambiguous statutes, is set to reshape the landscape of healthcare policy.

Description: Learn about the innovations of life and health products around the world. Expect to focus on: 1. Product development and pricing innovation in APAC region. 2. The Insurtech ecosystem creating new products by applying new technology and distribution channels in Latin America and Europe. 3. Products designed to supplement public sector offerings to close health protection gaps for underserved communities in the Middle East Africa and Asia Pacific region.

Description: Develop a better understanding of specialty drug trends and their increasing healthcare costs for more than the past decade by attending this webcast. With the introduction of price competition, you will see changes in the market for biosimilar products and patent-protected drugs. For example, the drug Humira will be gaining 10 biosimilar competitors in 2023. Alone, Humira can represent over 20% of total pharmacy spend for health plans. Join us and discover how price competition is a turning point for the pharmaceutical industry and will define its direction for the next decade.

Description: Investigate the importance of collaboration with accounting, underwriting, sales, marketing and other professions as an actuary when you attend this webcast. Cross-functional positions can cause unique challenges to arise, like various experts attempting to balance growth and profitability. Discover an opportunity to learn about relevant ASOPs and dive deeper into contemporary examples that highlight specific professionalism issues that can develop.

Description: As more gene and cell therapies enter the market at increasingly higher price points, they are ushering in a new era of medicine for rare diseases. Unlike most traditional therapies, gene and cell therapies typically have a short or one-time treatment administration and are anticipated to provide long-term clinical benefits. Actuaries must be prepared to assess, manage, and/or mitigate the risks associated with these therapies. This session includes three different perspectives—a regional plan, a stop loss/reinsurance carrier, and a health care consultant.