Description: This session will share insights on how to effectively evaluate and price the management high-cost claimants from three views: clinical, payer, and provider. Can predictive analytics help with underwriting? What are effective clinical mitigation strategies? Can VBC arrangements be used to reduce total cost of care, and how can that be priced in?

Description: This session will focus on the introduction to Medicare Research Identifiable File (RIF) data and how you can turbocharge strategic decision-making for Medicare stakeholders. Through real-world examples, we unravel the practical applications of this data for plan sponsors, pharmacies, pharmacy benefit managers (PBMs), and drug manufacturers.

Description: On July 1, 2023, CMS began their latest Medicare Oncology program, Enhancing Oncology Model (EOM) which was the successor to the previous Oncology Care Model (OCM). Despite a high level of interest during the application period, this model has been met with limited participation, with only 44 participants at the start of the program.

Description: The audience will learn about practical applications for actuarial and operational problems by using data science, how to collaborate effectively between actuarial, data science, data engineering, data management, legal and others and specific questions they need to ask the data science team to make effective data science solutions.

Description: This session will discuss essential theories and practical applications of deep learning for actuaries. Participants will gain insights on leveraging these cutting-edge techniques to enhance actuarial models and drive predictive accuracy.

Description: In this session, you will learn about key cost drivers in pharmacy trends, including but not limited to: New high-cost drugs, including gene therapies, that treat rare and/or expensive conditions such as spinal muscular atrophy (SMA), inherited retinal disease, hemophilia A and B, Duchenne muscular dystrophy (DMD), sickle cell anemia and cerebral adrenoleukodystrophy (CALD) Other cost drivers in the prescription drug category, including the emergence of GLP-1s, digital therapeutics, targeted immunomodulators, accelerated approval drugs and expanded indications The implications of the end of the COVID-19 Public Health Emergency (PHE) on the costs of COVID-19 vaccines, testing and treatment claims Downward influences on pharmacy costs, such as the availability of new generic drugs and biosimilars Emerging trends in pharmacy benefits manager (PBM) contracting, the initial portion of this discussion will be led by a pharmacist and former state pharmacy director.

Description: Review a recently completed research project for a multi-stakeholder data consortium on social determinants of health (SDOH). In this project, claims, external SDOH data, geospatial analysis, and machine learning models were used to examine several questions: How to identify SDOH vulnerabilities? How sensitive are the findings with respect to provider coding pattern variations? How much variability in cost can be explained by SDOH vs. morbidity? What are the key risk drivers revealed by machine learning models? The session will review the methodology and main findings from this project.

Description: Participate in a discussion with panelists from various functional areas andcompanies about the trend of increasing mutual attractions between private equity and insurance companies, the underlying strategic drivers from both sides, as well as the impact to both individual insurance companies and insurance industry as a whole. Take part in a conversation about the implications of insurers' obligations/changes to risk profiles and exposures when engaging offshore domicile of affiliated and unaffiliated reinsurers involved in the private equity-owned insurance business.

Description: The session will highlight trends in recent industry mortality and lapse studies that have been conducted, including areas where individual companies typically have limited data. The sources of data feature SOA studies as well as other industry studies conducted by consultants and/or reinsurers. Gain an understanding of current drivers of mortality and lapse experience for life insurance evidenced in industry studies, and an understanding of available data to supplement experience in areas where you may have limited internal experience.

Description: Focus on how innovative health care organizations develop their value proposition for their intended buyers. Presenters will share information about their specific solution and the methods used to derive credible savings estimates, ROI, and performance guarantees. Learn about data utilized, the methods deployed, advantages, disadvantages, and buyers' reaction. This session is expected to be technical, highly informative, and interactive with audience members.