Description: Knowing Dan and seeing him live his life in the community makes me a better Medicaid actuary. My experience as a Medicaid actuary makes me a better brother and guardian to Dan. I want to share our story and offer you our unique perspective on the Medicaid LTSS system through real-life examples. In this session, attendees can expect to learn about the following questions:

Description: Reference Based Pricing (RBP) efforts have increased in popularity as tools to reduce the cost of care. Now with the ability to use CMS health plan transparency information, organizations can estimate the impact of savings from the use of RBP. This session will share the results of an analysis of this in the form of a case study.

Description: This session will cover recent developments in paid family and medical leave (PFML) insurance in the US. We will provide an overview of existing and new PFML laws in states that have adopted leave legislation, and we will discuss the private insurance options in these states. In addition, we will provide an overview of PFML insurance offerings in states that have not passed leave laws, and we will discuss recent trends in PFML claim experience.

Description: It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome.

Description: This study would assess the impact of recent patient care innovation(s) on health care and the health insurance industry.

Description: In this session, participate in a mock negotiation of a typical value based contract taking on the role of either provider or payer and solving for the various negotiation challenges, objections, risk mitigations, data requirements, etc. from either party. Attendees will learn best practices and ideal tools and workflows to engage in when supporting VBC negotiations and gain insights into the typical challenges to equitable and agreeable terms.

Description: In this session, we will address the current landscape of the standalone Medicare Part D market and the challenges to its sustainability. Specifically, we will discuss some headwinds for plan sponsors due to the Inflation Reduction Act and future considerations for prescription drug plan (PDP) benefit design and pricing.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: This is Part 2 of 2 on changes affecting Medigap insurers. It focuses on marketing and regulatory differences between Medigap and Medicare Advantage that affect the competitiveness of Medigap plans.