Description: The cost of prescription drugs is top of mind for consumers, payers, and policymakers. While there have been many efforts to reduce pharmacy costs over the years, the problem remains. This begs the question “Where do we go from here?”. While each of the many policy proposals currently on the table help some people some of the time, none seem to address the root causes of rising prescription drug benefit costs.

Description: We will share the latest research from the Actuarial Innovation and Technology (AIT) Strategic Research Program, with a focus on research relevant to health actuaries. Attendees will learn about leading-edge technology that has impacts on actuarial functions, both broad and specific innovations and breakthrough technology, and the resulting impacts.

Description: En el seminario hablaremos sobre los nuevos flujos de tarificación, y nos enfocaremos en la inclusión del análisis geográfico en el proceso de modelado para optimizar la extracción del riesgo en modelos de Machine Learning.

Description: Today's provider reimbursement landscape

Description: In July of 2024, CMS will start operations on its new GUIDE model, designed to support people living with dementia and their unpaid caregivers. GUIDE is a TIN-centered model, offering a standardized approach to care with the goal of allowing people with dementia to remain in their homes for longer and improving their quality of life.

Description: The Social Security Disability Insurance (SSDI) program is a major source of income protection for disabled Americans. Private disability plans, especially group long-term disability plans, typically offset for SSDI benefits, so the programs are closely related.

Description: Advancements in machine learning modeling as well as new sources of data coming to the fore help feed the burgeoning industry of InsurTech applications in underwriting. By attending this session, you will learn about the latest developments in InsurTech applications in life/health insurance underwriting.

Description: While the higher general inflation in the broader U.S. economy hasn't emerged in the healthcare market (yet); there is expectations for it to have a lagged impact especially as the full impact of COVID on suppressed utilization emerges. As the healthcare system transitions past COVID, overall costs are expected to trend higher due to overall inflationary pressures as well as new treatments such as the highly anticipated new gene and cell therapies often with costs over millions of dollars.As costs rise, more companies are looking to self-insure their health insurance to control cost increases and are leveraging innovative stop loss programs including captives. Captive insurance markets have seen significant growth and diverse implementations allowing companies to self-fund while managing the risk of large claims and increasing costs. Payers are also looking to control costs and implement value based payment schemes to bend the trend curve and manage costs. Medicare has also adopted new value based payment programs (ACO Reach) which will impact commercial payers and are important to understand. Come gain an understanding of the historical and projected future medical cost drivers including the projected impact of new therapies and then impact on the stop loss markets. Additionally, you'll gain a deeper understanding on how recent innovations in the stop loss market such as the growth in the captive market, level funded and aggregate only products have helped employers manage their costs and overall risk profile.

Description: Dealing with more known unknowns? More scary knowns? Or unknown unknowns? What is the next unthinkable? What future events should actuaries actively be modelling and keep us up at night? The Catastrophe & Climate Strategic Research Program of the Society of Actuaries Research Institute (SOA) put forth a call for essays exploring these risks. The Program Steering Committee selected these essays submitted by Sam Gutterman and Max Rudolph to publish, and are awarding them each a prize of $500. The Catastrophe & Climate Strategic Research Program Steering Committee congratulates the authors and is happy to publish the winning essays on the SOA website.

Description: In this Society of Actuaries (SOA) Research Institute report, authored by consultants from Milliman, Inc. (Milliman) we aim to study the effects of hurricanes on human health: whether there is a relationship between hurricanes and the observed prevalence of healthcare utilization or certain health conditions among the affected population, whether this relationship can be observed through a healthcare utilization dataset, and whether there is an interaction between this observation and metrics of socioeconomic vulnerability.