Description: Session 10D: Medicare Advantage - Limit it or Use it to Replace Medicare + MedSupp?

Description: Session 6B: Unraveling the Mysteries of Cell & Gene Therapy Eligibility and Demand

Description: Session 9A: Medicaid Continuous Coverage Unwinding - A Risk Mitigation Case Study

Description: Virtual - Session 8D: An Application of Clustering Approaches in Value-Based Care

Description: Virtual - Session 8B: The Future of Transplantation and Risk Management

Description: Virtual - Session 6D: Beyond the Price Tag - Specialty Drug Administration Considerations

Description: Session 8F: Closing the Analytical Gap

Description: This session reviews the importance of using benchmarks in healthcare utilization management to improve organizational and patient outcomes and increase efficiency. It highlights how benchmarks can inform decisions about utilization management strategies and benefit members, payers, and providers. The presentation includes best practices, successful examples, and solutions to challenges, focusing on claim utilization, risk adjustment efficiency, quality metrics, and overall performance. Additionally, insights into the future of benchmarks and the value of analyzing the entire distribution of data for deeper insights will be shared.

Description: This session is designed to inform you about the current state of mental health and mental health care in the United States, as well as future trajectories. By exploring topics such as plan design, provider network, provider reimbursement, and other relevant channels, this session aims to enlighten everyone on existing challenges and the strategies being employed to tackle them. Notably, this will include and highlight proposed changes to the mental health parity. Additionally, attendees will hear from a mental health provider/academic on these topics to gain a non-actuarial perspective.

Description: In this video Matt Emery, FSA, MAAA, CERA delves into advancing Value-Based arrangements between plans and providers to uplift healthcare services. These initiatives aim to cut costs, refine coding accuracy, bolster quality measures, streamline care coordination, and enrich member benefits. Success hinges on engaging members effectively, executing robust cost strategies, utilizing predictive models, targeting specific populations, structuring payment plans, and optimizing data exchange for superior healthcare outcomes and enduring partnerships. Contributors: Matt Emery FSA, MAAA, CERA; Mitchell Momanyi FSA, MAAA; Jon Forster ASA, MAAA