Description: Hear about the new hope biosimilars bring in helping payers and patients manage the rapidly growing pharmacy spend. The Big Event, encompassing multiple Humira biosimilars, launches in 2023 and could set the tone for how much biosimilars can be expected to contribute to solving our pharmacy spend challenges. What will be the financial impact of the Big Event and this coming wave? What can be done to maximize adoption of biosimilars? What strategies are available to maximize savings for payers and patients?

Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.

Description: Session 1G: Rethinking Catastrophic Claims - Strategies for Sustainable Stop-Loss Pricing

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: 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: The article documents the efficacy of infra-low frequency neurofeedback regarding how it improves patient no show rates, decreases mental health symptoms by 40% or more, and self-harm and suicidal ideations.

Description: Read the November 14 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Read the October 2019 issues of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities. This is the second digital-only issue of the newsletter.

Description: Obesity rates in the United States have climbed to historic highs, with nearly 42% of adults now classified as obese—a trend with significant implications for the health care system. Among Medicare-aged individuals, obesity is strongly associated with chronic conditions such as diabetes, cardiovascular disease and musculoskeletal disorders, all of which increase health care utilization and spending. As costs continue to rise, understanding the financial impact of obesity management is increasingly important for policymakers, payers and providers. This analysis uses detailed traditional Medicare claims and eligibility data to examine how obesity levels relate to health care expenditures and how costs change as members move between different diagnosed obesity categories over time

Description: Critical Illness (CI) insurance in Asia has evolved through data-driven insights, adapting to changing medical, demographic, and lifestyle trends. Gen Re’s CI Data Insights Study, covering Mainland China, Hong Kong, Singapore, Malaysia, and Thailand, highlights how advances in screening, especially for cancers, have influenced incidence rates and claims. Regular updates to CI definitions and product structures are essential for sustainability, as seen in the handling of thyroid and prostate cancers. Lifestyle factors like BMI also impact cardiovascular risk. A multi-dimensional approach combining robust data monitoring, proactive product updates, and wellness promotion ensures CI insurance remains relevant and sustainable.