Description: Cost is a key outcome metric used by actuaries and others to determine the value of a benefit or program in health insurance. However, typically, costs assessed include only the direct costs of the program, not any indirect costs or savings, such as those associated with reduced spending on other services.

Description: Virtual - Session 3C: Clear as Mud - The Impact of Price Transparency

Description: Guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting.

Description: The aftershocks of the COVID pandemic will pass --- eventually. Government subsidies and spending soared in 2020 to meet the challenges of the pandemic. Health expenditures leapt from 17.6% of GDP to 19.7%, and then dropped to 18.8% in 2021, and will fall again to 18.2% (projected) in 2022, but are expected to return to the long-run trend by 2024 and gradually rise thereafter. However, during the next few years most attention will be paid to dealing with complex aftershocks from the flood of Covid funding in 2020 and 2021, a surge of inflation in 2022, and a looming recession in 2023.

Description: It goes without saying that the analysis of data is a key aspect of actuarial practice, but do traditional actuarial approaches allow us to see the whole picture? Effective data analysis is also key to the identification of health disparities and measuring progress on health equity. Actuaries and others analyzing data for health equity purposes find themselves looking at data differently.

Description: The instructors in this boot camp session will highlight the SOA's work on an updated Medicaid underwriting margin model. This research project includes an excel model, a set of instructions and a paper describing the key components of underwriting margin, including cost of capital and risk margin.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: Experience a comprehensive overview of the current purchasing landscape for health care services, with a specific focus on how healthtech start-ups can break into the employer-sponsored health care market. You will learn about the key players in the healthcare industry, as well as challenges that new entrants (+ B2B vendors more generally) face in selling their services to employers and health plans.

Description: Patients with diabetes make up 25% of health care spending in the US, and a variety of solutions to address the high cost of diabetes exist today, including disease management programs, clinical interventions including bariatric surgery and GLP-1 drugs, and food as medicine programs.

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.