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: 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: This session will give an update on the latest in SOA Health Research. The session will also provide an overview of the health research process with additional information on upcoming SOA volunteer opportunities in Health Research. There will be a presentation on one or more SOA Health Research Projects recently published or soon to be published.

Description: This session includes a new idea based on dynamic treatment regime work (OWL) and integrating cost into this work. This will enable identifying the best treatment for a patient based on both outcomes and cost. This is novel for actuaries because in previous analysis we have used cost only in the after-analysis, whereas here we use it in the actual analysis and treatment identification. Moreover, this analysis provides a way to consider multiple treatments for a patient (including the no treatment option) and choosing among those multiple treatments, for both outcomes and cost. This session will share the background theory and set up a case study. The case study will parallel what is in the analysis in the book by Ian Duncan 'Predicting Hospital Readmission with Case Management Recommendation.' This analysis will then go further to compare a situation where there are multiple potential case managers. Also, this will potentially explore care pathways and choosing the best care pathway for a patient based on health outcomes and cost combined.

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?