Description: Discover the multitude of risk transfer solutions and payment models available to health claims payers for cell & gene therapies in this Society of Actuaries webinar. Delving deeper into the topic, we will examine the different types of solutions, weigh their pros and cons, and explore the future prospects of this rapidly evolving area of the healthcare landscape. By expanding upon the pricing and risk exposure discussion from session two, this webinar provides valuable insights into the dynamic market for cell & gene therapies and its implications for actuaries.

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: Attendees will see how care coordination and navigation may improve outcomes when integrating across acute and long-term care needs within Medicare and Long-Term Care Insurance products.

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: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: The Society of Actuaries will host two great events for the health actuarial community, bringing together the industry’s leading actuaries, analysts and professionals to network and discuss impacts of the latest marketplace factors and trends.

Description: Gather with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, pension, investment, product strategy, and more.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.