Description: Medicare Advantage Organizations (MAOs) have made dramatic changes to the benefits and plan premiums they've offered members over the past years. Hear about information on the changes to benefits and plan premiums offered over the past few years. Find out where these strategic items are currently (for CY2024 bid year) and get ideas on what might come in the next few years. Presenters will discuss recent proposals and rules from CMS that will impact the current and future landscape. They will also compare these items in relation to the fee-for-service (FFS) Medicare market. This session will help you gain a deeper knowledge of the Medicare Advantage, Prescription Drug Plan, and Medicare FFS landscape and walk away with some strategic thoughts on potential paths MAOs may take from here.

Description: The Social Security Disability Insurance (SSDI) program is a major source of income protection for disabled Americans. Private disability plans, especially group long-term disability plans, typically offset for SSDI benefits, so the programs are closely related.

Description: Discuss the dramatically changing provider landscape, as well as the innovative solutions being leveraged by providers to address the intriguing opportunities and complex challenges. Among the questions to be answered are the following: How can providers capitalize on employers’ desire to contract directly with local providers? What's the path for providers to develop employer stop-loss (ESL) capabilities to maximize network value/impact? Can providers create a risk portfolio including ESL for local employers, their own employee plan, and other delegated risk arrangements such as Medicare Advantage? How can captive insurers support a provider's risk strategy?

Description: While we are eight miles from Capitol Hill and a week away from the 2024 presidential election, actuaries and health policy experts will discuss the campaign platforms of the major parties and presidential candidates and the potential health policy implications in the next four years. Focus will be on the changing dynamics within ACA marketplaces with the knowledge benefit of both major party candidates having presidential administrative experience in the ACA environment. Session attendees will be well-equipped to discuss the post-ACA health policy implementation of Presidents Biden and Trump, recent policy proposals from both sides of the political aisle, and potential legislative/regulatory changes on the horizon.

Description: Join our exciting panel of health actuaries, ready for any challenge! Got an ACA puzzle? We've got the answers! Tackling a valuation dilemma? We're here to crack it! Facing a professionalism quandary? We'll navigate the complexities! Dealing with regulatory worries? We're your guiding light! Every question is welcome - there's no such thing as a silly question! Learning Outcomes: - Attendees will have the opportunity to get answers to their questions.

Description: The Inflation Reduction Act (IRA) introduced major changes to the Part D program. This session will unpack the impact of IRA's benefit redesign in 2025 premiums, costs, and beneficiary choices, and the implication of drug price negotiation in 2026. We will discuss how Part D plans are adapting to these changes, lessons learned from the 2025 bids, and what we can expect in 2026 after the price negotiation of the top ten Part D drugs.

Description: Explore the value and cost of prescription drugs, how they should be defined and measured and the effects various stakeholders in the pharmacy ecosystem can have on these factors in the latest webcast. You'll investigate the impact of coverage, formulary and rebate negotiations and related benefit design. Find out how actuaries can answer questions related to the prescription drug industry, in addition to improving the access, quality and affordability of prescription drugs in the United States. Join us for this webcast and come learn about value-based contract design, negotiations, implementation and administration for prescription drugs.

Description: Understand the role of food based interventions in health care. Learn the difference between produce prescription and medically tailored meals. Review new policies that will affect Medicare and Medicaid populations. Evaluate the possibility of health cost savings due to these interventions.

Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: The U.S. health care system continues to have its problems. It costs too much and even with public policy developments we are not meeting the desired objectives. What's next? What else can we do? Discuss some of the emerging ideas that are being pursued and the likelihood of their success at solving our collective problem.