Description: Delve into the factors contributing to the rapid growth of high-cost medical treatments and how payers can manage the financial exposure that comes with them. Learn about the current and near-future state of million-dollar medical costs, as well as the trends shaping the industry. By attending the session, you will have a better understanding of the underlying drivers of high-cost treatments and will be equipped with practical strategies for mitigating their financial impact, including risk management techniques, cost containment measures, and new payment models. Additionally, you will be able to identify key considerations for implementing these strategies in their own organizations.

Description: Actuaries team up with Payers and Providers, to share insight into their data-driven approaches for improving health plans' CMS Medicare Star Ratings, which leverage experiential analytics to create solutions. 'Experience' is the king-it is broader umbrella, which includes and addresses engagement, cultural competency, equity, cost, and lastly, 'quality'. By attending this session, you will be better equipped to turn real-life data into actionable business solutions-essentially, data science in action. Further, you will better appreciate the importance of stars and risk adjustment in the Medicare Advantage space, along with the consequences of coming up short.

Description: The Inflation Reduction Act represents the largest change to the Medicare Part D program since its inception in 2006. With a complete redesign of the Part D program coming in 2025 (the next bid cycle), there are health plan, operational and analytical challenges that lie ahead. In this session, you will: Hear highlights on some of the key changes occurring in 2025 Learn about key considerations for health plans and other stakeholders in the Medicare and commercial markets Discover potential winning strategies and potential analyses that could inform those strategies

Description: State Medicaid programs have broad flexibility to establish their own payment methodologies and rates for hospital services. Many states direct additional funding to populations, services, and hospitals where Medicaid comprises a disproportionate share of total business, or where there are other access concerns (e.g. rural providers). Actuaries can play a key role in determining where those additional funds would have the most benefit.

Description: Gain a clearer understanding as a provider and a payer discuss the insights gained from being involved in value-based care. Learn about the payer's perspectives on how to develop a value-based contract, the negotiation process and the support they provide the provider. Discover the provider's perspectives on how value-based contracts have impacted them, the analytics they are developing and the collaboration with the payer.

Description: Get up to date on the current and potential use of artificial intelligence (AI) in the health care space. In this interactive session, you will learn how AI is being used today and discover its potential to reshape and revolutionize health care. Take advantage of the opportunity to find out how AI can influence patient experience in every phase of health care delivery, and join the conversation about the challenges and limitations that arise with the use of this technology.

Description: Discuss changes in group life waiver of premium claim recovery and mortality experience since the 2005 table was released, the development of the 2023 table, and the new statutory valuation standard approved by the National Association of Insurance Commissioners (NAIC).

Description: The true cost of a drug and its therapeutic outcome is impacted by a myriad of factors. This session will utilize case studies in high-cost, chronic diseases to illustrate to participants what factors can be critical to evaluating the true cost of a pharmaceutical intervention. Differing from session one, session two will focus on site of care, buy-and-bill aspects, and the differences between a medical and pharmacy benefit and how these factors ultimately impact the total cost of patient care.

Description: Attendees will hear examples of individuals with medical conditions which are either being treated by gene therapy or have gene therapy treatments in development. Attendees will learn about what gene therapy is, current development methods, treatment efficacy, and expectations for future gene therapy treatments. We will explore funding challenges for gene therapy and potential methods to manage costs for gene therapy treatments.

Description: This session will explore a solution to manage health expenses, a bit like the retirement risk managed by the three-legged stool, that is coming from government benefits, employer pension plan, and registered retirement savings plan. The solution could be called a Registered Health Savings Account (RHSA), and could then complement public coverage, and group insurance coverage