Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.

Description: Health care continues to move from a fee-for-service model to a value-based care model. Hear from our expert panel how actuaries can play key roles in designing and contracting value-based agreements, monitoring experience, and driving results, as well as measuring value. The discussion will cover different structures currently in use, types of services covered (total cost of care, claim service lines, specialties, condition based, pharmacy products, etc.) and nuances by market (Medicare FFS, Medicare Advantage, Commercial, Medicaid). Listen to presenters discuss latest innovations in the value-based care space, as well as how current events have impacted these contracts. In this interactive session you will also be able to ask our diverse panelists questions.

Description: This session will explore the evolving landscape of accident and health valuation, with a special focus on GAAP Long Duration Targeted Improvements. Discussion will delve into the intricacies of change brought by GAAP LDTI for calculation of both Lifetime Future Policy Benefits (LFPB) and Deferred Acquisition Costs, as well as potential downstream impacts to other activities related to general GAAP and STAT reserving such as experience analysis, model system conversion, financial planning and analysis, and statutory margin analysis. Attendees should be able to connect accounting and financial reporting concepts under GAAP LDTI to opportunities for technology modernization, improved transparency of financial analytics, and important considerations unique to Accident and Health products.

Description: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: There are many ways to actively utilize BE approaches – and implementing these important tools can help insurers in many ways.

Description: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care

Description: The session is based on an article of the same name featured in the January, 2023 issue of Health Watch. It gives a step-by-step method of how to apply the average paid PMPM method to calculate IBNR with zero run-out, as opposed to current methods, which generally require a three-month run-out period. Methods for obtaining confidence intervals for the IBNR estimates will also be discussed.

Description: The Society of Actuaries will host two great events for the health actuarial community, bringing together the industry’s leading actuaries, analysts and professionals to network and discuss impacts of the latest marketplace factors and trends.

Description: Gather with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, pension, investment, product strategy, and more.