Description: Explore SOA-sponsored research on Social Determinants of Health (SDOH) during the How Does Where You Live Impact Your Health webcast. Dive into SDOH data and modeling that will focus on cluster analysis. This will help determine the overall impact of your area's affect on your health and life. This webcast also covers an overview of the existing SDOH-related programs that may affect or intersect with health plan or provider SDOH initiatives. Discover the importance of the place you live and future impact of your overall health.

Description: Get highlights from recently published and upcoming research from the SOA Research Institute, including work on specialty pharmacy and 'Valuing the Impact of Technology in Health Care'. Presenters will focus on the financial impacts of these issues as well as trends and other actuarial considerations.

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: 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: Valuation at the heart of health insurance

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: Come learn how Maryland is leading the charge in improving affordability for its individual market enrollees. Learn about the success of the state's 1332 reinsurance program and additional initiatives including further Medicaid expansion, additional state and CSR subsidies, and eligible population expansions.

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: Health care continues to move from a fee-for-service model to a value-based care model. Hear from our expert panel how actuaries can play key roles in designing and contracting value-based agreements, monitoring experience, and driving results, as well as measuring value. The discussion will cover different structures currently in use, types of services covered (total cost of care, claim service lines, specialties, condition based, pharmacy products, etc.) and nuances by market (Medicare FFS, Medicare Advantage, Commercial, Medicaid). Listen to presenters discuss latest innovations in the value-based care space, as well as how current events have impacted these contracts. In this interactive session you will also be able to ask our diverse panelists questions.

Description: The Affordable Care Act (ACA) changed the health insurance value proposition for lower-income Americans. Consequently, the uninsured rate has dropped dramatically since the implementation of ACA marketplaces and the expansion of state Medicaid programs to a broader eligibility group. It is not difficult to connect the change in financial dynamics to the increase in health insurance coverage. At the same time, many Americans remain uninsured due to non-financial barriers. Identifying solutions to further reduce the uninsured rate is more difficult than intuitively 'spending more federal money'.