Description: The need for LTC services is projected to increase as the general population ages. Many LTC carriers have helped meet this demand but are looking for new ways to mitigate underpriced risks and to improve policyholders' quality of life. Aging-in-place interventions can be an effective method to mitigate financial risks and improve health outcomes. However, many carriers face challenges to prove financial benefits/ROI, quantify program effectiveness, or simply don't have clarity on how to start and implement these initiatives effectively or operationally.

Description: Hear about some applications using quantile regression-derived individual and group claim distributions and how they may be used in various traditional health care modeling situations. The session will not focus on the technical use of quantile regression to obtain estimates of claim distributions, but more so is intended to focus on the uses of the distributions in actuarial modeling and the additive framework in assessing claims distributions. Presenters will show how actuaries can better assess risks by focusing on the individual- and group-specific claims distributions as opposed to traditional point-estimate-centric models.

Description: We welcome all genders to join us for this engaging and thought-provoking Women's Leadership Forum. This year's event will feature engaging presenters and interactive breakouts. More details to come! This forum begins with breakfast. It is open to all meeting attendees free of charge. If you plan to attend, please register in advance.

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'.

Description: The presenters give a history lesson on the origin of CMS Medicare star ratings, including why this demonstration was originally created and how the program has worked over the years. The discussion will cover both the evolution of the underlying measures and the financial impact to Medicare Advantage stakeholders. By attending the session, you will have a stronger understanding of how member experience and outcome-based measures can be factored into the funding within a health care system to better align incentives among various stakeholders.

Description: Come discuss the interaction between defined benefit (DB) plans and defined contribution (DC) plans. You'll hear more about the impact of DB plans on DC plan design and vice versa. Join us and learn about the differences in DB and DC plan governance and cross-over opportunities between these plan solutions.

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: 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: Actuaries are increasingly being asked to incorporate Economic Scenario Generators into their work. Whether it be a Risk Neutral model for pricing or a Real-World version for Economic Capital modelling, using these tools can help produce a much more robust analysis. Unfortunately, these models and their underpinnings are also very complicated, which can lead to confusion. Come watch the presenters try to demystify some of this. In particular, they will address the following questions: • What is the difference between Real-World and Risk Neutral scenarios? • When should I use one or the other? • How are these models calibrated? • What are some of the misconceptions about these models? At the conclusion of the session, attendees will be able to: • Explain the difference between Real-World and a Risk Neutral scenarios • Understand the appropriate usage of both • Identify some of the calibration questions that go into developing an appropriate set of scenarios • Avoid some of the common misconceptions about these scenarios

Description: How do we take a Minimum Viable Products (MVP) approach to launch new insurance products? Join this moderated discussion and focus on three key development aspects: Distribution, Systems, and the design and pricing of the Insurance product itself. Come discuss reasons to choose an MVP approach and how it solves many of the product launch challenges.