Description: CMS provides a significant and growing amount of information that can be leveraged by actuaries. Between the public use and research files CMS makes publicly available, large amounts of information that can be assimilated to help understand the who, what, when, where and how of Medicare. With the CMS allowance of supplemental benefits to address SDOH, adding SDOH data into your data landscape is critical to better understand your members' cost drivers. The presenters will focus on the depth and breadth of data available, summarize any restrictions on the use of the data, and identify areas where access to the new data can provide more meaningful insights.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: Read the October 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities. This is the first digital-only issue of the newsletter.

Description: Attendees will see how care coordination and navigation may improve outcomes when integrating across acute and long-term care needs within Medicare and Long-Term Care Insurance products.

Description: Anti-obesity medications have been met with reluctance from payers and employee benefits consultants who often lack analogs or empirical data to estimate the cost impact of new therapies coverage. Health plans considering coverage of anti-obesity medications will need to assess and manage the potential costs of covering these new therapies in context of their overall obesity management strategy, including coverage of nutrition counseling, weight management, and bariatric surgery.

Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.

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: Read the November 14 2019 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Read the October 2019 issues of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities. This is the second digital-only issue of the newsletter.