Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.

Description: How do we take a Minimum Viable Products (MVP) approach to launch new insurance products? Join this moderated discussion and focus on three key development aspects: Distribution, Systems, and the design and pricing of the Insurance product itself. Come discuss reasons to choose an MVP approach and how it solves many of the product launch challenges.

Description: Join a panel of experienced Health Actuaries as they discuss the significance of actuaries' contributions to making U.S. health care better and how actuaries might enhance their contributions to fixing problems.

Description: As we entered 2014, actuaries became familiar with three risk stabilizing mechanisms in the early years of the ACA marketplaces, colloquially known as 'the 3Rs'. As we enter 2024, there is renewed focus on rating compliance and risk adjustment. Speakers will highlight pricing considerations when determining cost-sharing reduction premium loads as well as related issues pertaining to risk adjustment and metal tier pricing.

Description: The momentum towards value-based care has increased focus on how payers attribute accountability for the cost and quality of member care to providers. The current landscape has a myriad of methodologies and accountable parties. Examine the ideal future state of attribution discussing trade-offs in goals (e.g., population coverage vs. member influence), accountable parties (e.g., should third-party vendors be involved?), and methodologies.

Description: "This video by Danika Turner is an introduction to Medicare Advantage revenue, specifically focusing on how Part C revenue works for individual Medicare Advantage plans. It explains how health plans participating in the Medicare Advantage program are paid by the Centers for Medicare and Medicaid Services (CMS), including the impact of Star ratings, risk adjustment, and county-level CMS benchmark rates on revenue. The session aims to simplify the main variables of the revenue calculation and uses conceptual examples for individual MA plans, excluding certain populations like Employer Group Waiver Plans and members with End-Stage Renal Disease or in hospice. The video also covers the basics of Medicare-covered services, mandatory and optional supplemental benefits, and the calculation steps for determining CMS Part C revenue per member per month.

Description: Life insurance products have evolved over time from the early mutual aid societies paying benefits when members died to comprehensive products covering a range of financial needs over an individual’s lifecycle. While some life insurance benefit riders have been offered for decades and are well-established, recent years have seen a number of accelerated benefit riders being introduced by carriers for a growing range of covered triggers. Join us as we discuss these acceleration and extended benefit riders, trends and innovations in the space, and discuss challenges and actuarial considerations in designing, pricing, and modelling them. We will also explore issues carriers have experienced, how to consider the interactions between these benefits and the underlying mortality coverage, reinsurance considerations, and more!

Description: This session will provide an overview of the landscape of accident and health insurance valuation. Attendees will gain an understanding of key concepts and various actuarial techniques employed in the valuation of accident and health insurance policies. By incorporating real-world perspectives and experiences, this presentation equips attendees with actionable knowledge to enhance their understanding and approach to accident and health valuation in an ever-evolving insurance landscape.

Description: This webcast will explore the shifting landscape of healthcare costs. It will cover healthcare trend basics, recent developments, and what’s ahead. Drawing from comprehensive data analysis and industry insights, this presentation promises to equip attendees with actionable knowledge to navigate the complex terrain of healthcare expenses effectively.