Description: The Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

Description: What is the value of the health care we pay for? As medical inflation continues to outpace general inflation, this question is more important than ever. As actuaries, we are often called upon to evaluate the value of medical care. Are the ways the value equation is commonly constructed reflective of our aspirations as a society? What gravitational forces do we need to be aware of that perpetuate the status quo, mental biases and methodological pitfalls and how do we actively work to correct for them?

Description: Misalignment in value-based care approaches between payers and market segments (Medicare, Medicaid, self-funded employer groups, and commercial insurance) creates significant headwinds and friction for health care providers seeking to succeed in an environment that is moving toward more value-based care models and payment approaches. However, while multi-payer approaches in value-based care are critical to eliminating these misalignments, uptake in such programs has been lagging for a variety of reasons. Hear about lessons learned from a selection of specific multi-payer initiatives to understand what went well and what challenges were encountered in expanding these initiatives more broadly. You should be able to walk away from this session with an appreciation of the potential for multi-payer approaches and the challenges faced in gaining traction with them.

Description: Learn how insurers provide new opportunities for efficiency and value creation from product design and underwriting through customer engagement and claims. Glimpse some industry use cases for Gen AI and its outcomes as observed by the first movers.

Description: The Part D program is funded through a variety of government subsidies and manufacturer discounts. The federal reinsurance, initially designed as protection from catastrophic spending, became a primary source of subsidies for the program. When the Inflation Reduction Act (IRA) is fully implemented in 2025, the funding of Part D will realign to its original intent.

Description: Learn about the innovations of life and health products around the world. Expect to focus on: 1. Product development and pricing innovation in APAC region. 2. The Insurtech ecosystem creating new products by applying new technology and distribution channels in Latin America and Europe. 3. Products designed to supplement public sector offerings to close health protection gaps for underserved communities in the Middle East Africa and Asia Pacific region.

Description: For this session, we will explore difference in Medicare products from Traditional Medicare to Medicare Advantage. It will clarify different parts of the benefits and the role of Medigap plans. We will then discuss the impending changes in Medicare Part D due to the Inflation Reduction Act, highlighting redesigned benefits, stakeholder impacts, & potential risks. This informative session aims to demystify Medicare, providing insights into existing structures and forthcoming alterations.

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: Explore historical trends in enrollment, carrier participation, and competition over the first 10 years of the individual marketplace as a basis to frame what the future could hold for the next 10 years. Draw parallels to other lines of business (e.g., Medicare Advantage, employer group) as we look at how the market may evolve and the capabilities required to succeed. This session would be valuable for anyone interested in consumer purchasing behavior, quality and risk adjustment, employer benefits, provider dynamics, and the individual market more broadly. By attending this this session, you will be able to articulate the impact of recent legislation and regulatory actions on the Individual market, including subsidies, employer funding vehicles (e.g., ICHRA), distribution channels, and product requirements.

Description: As more gene and cell therapies enter the market at increasingly higher price points, they are ushering in a new era of medicine for rare diseases. Unlike most traditional therapies, gene and cell therapies typically have a short or one-time treatment administration and are anticipated to provide long-term clinical benefits. Actuaries must be prepared to assess, manage, and/or mitigate the risks associated with these therapies. This session includes three different perspectives—a regional plan, a stop loss/reinsurance carrier, and a health care consultant.