Description: Address issues in value-based contract accounting from an actuarial perspective. In Medicare and ACA business, what issues does risk adjustment present to value-based contract accounting? In Medicare, what issues do Part D present in value-based contract accounting and what are possible solutions? What are the issues in the use of provider stop loss in value-based contract accounting? Are there issues in the timeliness of claims in value-based contract accounting? Are we giving providers enough information for them to manage their population? How do we deal with deficit accounts? What are the pros and cons of capitation, gainshare, and full risk in value-based accounting?

Description: There exists profound health and access disparities among people from different demographics and socioeconomic backgrounds. Health equity is now a central policy directive for the U.S. government and CMS. Speakers representing policy, health care delivery and actuarial spaces will help you discover what health equity policy directions may look like, the challenges health care providers are facing and how actuaries can contribute to the effort in bridging the health equity divides.

Description: Gene therapy is a quickly evolving field and will continue to grow as a risk concern for many health plans, stop loss insurers and reinsurers. Currently, there are only two approved gene therapies in the U.S., but that number is expected to escalate starting in the fall of 2022. Revisit the experience plans have had with the first two gene therapies, discuss plan design and network considerations in light of gene therapy, and discuss the actual composition of the near-term pipeline along with a range of modeled financial impacts and considerations for payers.

Description: Join us for an insightful webcast as we delve into the far-reaching implications of the recent Supreme Court decision to overturn Chevron deference. This landmark ruling, which previously granted federal agencies significant leeway in interpreting ambiguous statutes, is set to reshape the landscape of healthcare policy.

Description: With the 2024 presidential election one week in the rear-view mirror, actuaries and health policy experts will discuss the potential health policy implications in the next four years in relation to the election results. Focus will be on the changing dynamics within Affordable Care Act (ACA) marketplaces with the knowledge benefit of the next president having administrative experience in the ACA environment. Session attendees will be well-equipped to discuss the post-ACA health policy implementation of presidents Biden and Trump, recent policy proposals, and potential legislative/regulatory changes as a result of the 2024 election outcomes.

Description: "Advancing health equity is one of the five strategic objectives outlined in the CMS Innovation Center's strategic objectives for the next ten years and is an increasing area of focus across many states. Focus in on recent developments in addressing Medicaid beneficiary needs related to social determinants of health (SDOH), health-related social needs (HRSN), and health disparities and inequities in Medicaid. Several states have introduced non-traditional benefits into their programs in recent years to address these areas, such as various types of housing supports, nutrition-related benefits, and enhanced/advanced case management support. Expect a discussion on the benefits introduced recently in states such as AZ, CA, MA, NC, and OR, including funding considerations around these benefits as well as the 1115 demonstration waiver authorities granted to these states to allow coverage for these non-traditional health care services.

Description: "Examine the exciting possibilities for artificial intelligence (AI) in health care and its potential to transform the patient journey. You will learn about the various touchpoints where AI is being applied along the patient/care journey, including provider search tools, claims analysis, and fraud detection. By attending the session, you will be able to: Have a comprehensive understanding of the opportunities and challenges presented by AI in health care Evaluate the potential impact of AI on their own organizations Be equipped with strategies for effectively implementing AI solutions and maximizing their benefits for patients, providers, and payers"

Description: Model design is an important part of being an actuary, and the SOA highlights the importance of the actuarial control cycle of model design, evaluation and monitoring. What tools are at our disposal for these steps? When should we be concerned or excited about model performance? Can we, and should we, use machine learning tools to assist with model improvement or development?

Description: The health care sector in general, and physicians in particular, are a large and important part of the market for group and individual insurance products. Explore a variety of subjects related to physicians and disability insurance, including experience trends, purchasing trends, external factors affecting physicians, and the impact of the COVID-19 pandemic.

Description: Are you interested in learning about technical changes to the risk adjustment methodology, Texas implementing effective rate review and premium alignment rules, new rules on standard benefits and network adequacy? Discover some of the reasons why the 2023 ACA marketplace will look much different in the first year of the Biden administration setting the tone with annual ACA rules. Listen to a panel of consulting actuaries and the Chief Actuary from the Texas Department of Insurance who are deeply involved in state and federal policy, risk adjustment methodology, and continuous monitoring of changing market dynamics. Explore new federal rules, efforts to strengthen enforcement of rating compliance, current considerations in risk adjustment methodology, and the ACA market outlook for 2023 and 2024.