Description: Inspired by Seinfeld's Festivus celebration, our panel will conduct a lighthearted but technically robust airing of grievances related to the Medicare Star Rating program. Over the past decade, the Medicare Star Rating program has undergone an array of methodological changes.

Description: Session 2D: Thinking Local - The ‘Oh Wows’, and 'Oh Nos' of Medicare Advantage for Regional Plans

Description: Lunch Session - Celebrating 15 years of the ACA: Texas’ Legislative Journey and Market Success

Description: Session 10C: Redesigning the U.S. Health Care System - You Vote

Description: Traditional Medicare [TM] has many coverage gaps and no out-of-pocket maximum. Most members must purchase a Medicare Supplement Plan and a Part D plan for pharmacy coverage. Over 50% of members have opted for a Medicare Advantage [MA] plan that replaces TM and the need to purchase a Supplement and (in most cases) a Part D plan. All this for less cost to the member, but at a greater overall cost to the federal government even though MA plans provide TM benefits for less than it costs the government. The attendee will learn why this occurs. However, given these facts, the focus of the session will be on the future of Medicare: namely, should the parameters regarding MA bids and payments be limited to what is paid for TM, or can we take the best administrative techniques of MA and TM to provide more robust benefits for all Medicare members at a cost no greater than the government is currently paying? Or is there an even better idea?

Description: Prescription drug markets are undergoing rapid change - significant policy changes implemented through the Inflation Reduction Act, Congressional interest in long-awaited 340b reform, and a growing direct-to-consumer market have already changed the landscape significantly. The ongoing effects of these changes will continue to evolve for many years. Hear from leading prescription drug actuaries and pharmacy policy experts on what these changes mean for prescription drug markets and US healthcare more broadly.

Description: At the conclusion of the session, attendees will be able to understand the potential for using global population health mortality and morbidity data in actuarial contexts. Using the Global Burden of Disease project as a resource, this session will discuss how novel population health research can be used to complement and fill in the gaps of existing input data sources for actuarial analysis and modeling. Presenters will share the latest academic research on the topics of demography, life expectancy, health-adjusted life expectancy, causes of death and disability, comprehensive disease incidence and prevalence metric, measures of disease burden for patients and populations, modifiable risk factors where there are opportunities to make interventions and improve health outcomes, and disparities between and within populations. This research is globally comprehensive and comparable between different markets and disease areas. The session will cover the motivation and purpose of GBD, a brief description of the models used, and dive deep on some selected use cases in actuarial contexts. Audiences will leave with: 1. Understanding challenges and opportunities in measuring disease burden comprehensively and consistently 2. Understanding relevant health metrics, including the drivers of future mortality and morbidity 3. Ideas for applications of epidemiological research in your work

Description: This session will review the latest developments in the Affordable Care Act (ACA) marketplace, including a discussion of hot topics, challenges, and opportunities on the horizon. Specific topics will include cost-sharing reductions (CSR) loading and the impact on subsidized rates across states (e.g., mandated loading in NM), the interaction of American Rescue Plan (ARP) subsidy expansion, and the impact on ARP-enhanced subsidies end.

Description: Much of the work performed by disability insurance actuaries depends on the availability of accurate and detailed data, which is not always as simple as it sounds. Explore a variety of data challenges faced by disability actuaries, along with potential solutions. Potential topics include finding relevant data, the impact of poor data on valuation work, the impact of new privacy rules, and the potential bias in the data used to develop predictive models.

Description: CMS launched the value-based insurance design (VBID) model in 2017, allowing health plans to offer innovative supplemental benefits and incentives to beneficiaries to use high-value services specific to their health care needs or socioeconomic position. CMS's stated goal is to encourage health plans to implement strategies that focus on health equity. The model has evolved over time and has grown tremendously in popularity over the years since it was introduced.