Description: This session series is sponsored by Zelis Claim analytics produces valuable insights about provider cost, quality, and referral patterns. Provider networks can be created around high-value providers to improve clinical outcomes while lowering the cost of care. Programs to improve provider performance and/or incentivize members to choose high-value providers exist, but how do you bring all of this together to achieve desired outcomes? Join us to learn how to leverage provider level analytics to build and optimize a network with high-value providers at the center. Analyze the network for competitiveness and adequacy and demonstrate progress toward network cost saving goals to key stakeholders by modeling claim data for a member population. Finally, ensure the success of your network through an incentive program that shifts utilization to those high performing providers. By attending this session, you will be able to: - Build a realistic provider network with high-value providers at the center. - Evaluate the overall financial impact of network build and optimization efforts. - Learn about an innovative member incentive program.

Description: What if a blood test can detect more than 50 types of cancer, including those in early stages? A biotech company, GRAIL, has developed the first-to-market Multi-Cancer Early Detection test and launched it for commercial use in 2021. Join us to learn how Munich Re and GRAIL are partnering to bring its Galleri test to the life insurance industry. You will also explore how we as an industry can help save lives by detecting cancer earlier and share perspectives on some early findings and cost-benefit analysis

Description: This webcast will focus on recently published health research which examines the impacts of social determinants of health on oral health outcomes as well as on chronic kidney disease progression. Participants will gain insights on how different aspects of social determinants of health can impact how healthcare is delivered as well as the impact on health care costs.

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: 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: Ask all your questions related to value-based care to a panel of experts. How do we handle a tough negotiation? How do you measure impact in a value contract? What analytics should be considered for specific contract evaluation? What are current trends in value-based care in Medicare, commercial, and Medicaid? We've got a panel of experts to help you get answers.

Description: A new wave of biosimilar launches is creating downward pressure on average sales prices (ASPs), disrupting reimbursement to providers, providing opportunities and challenges to payers and GPOs, and upending the gross-to-net math for manufacturers. In this session, we will explore the implications of the ASP death spiral on the drug supply chain and its interplay with price transparency efforts.

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 among your peers based on what you already know from your own experience as well as what you learn in this session, and then deliver your verdict accordingly.

Description: Explore the dynamic intersection of health insurance data and diverse industries beyond traditional health insurance providers. This session will delve into how life science companies, pharmaceutical manufacturers, device manufacturers, and others leverage health insurance data to drive innovation and decision-making.

Description: Tailored for newly minted ASAs/FSAs or those venturing into the realm of reserving, as well as seasoned actuaries in need of a recap, this session is a gateway to the mysteries of IBNR reserving, unraveling various methods and assumptions. Embark on a journey through the construction of claims triangles and the crafting of completion factors, delving into the enigmatic realms of seasonality, trend analysis, and outlier claims.