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: 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: Patients with chronic conditions such as musculoskeletal pain, diabetes, and hypertension impact 50% of the US healthcare population, consume more than 85% of healthcare costs, and often require a higher volume of care, expensive imaging, testing, and emergency procedures, and long-term high-cost drugs. Managing these conditions through innovative digital health interventions provides a significant opportunity for higher-touch and more-effective management that will result in lower costs.

Description: This presentation will explore innovative approaches to high performance networks (HPN). The session will compare the more traditional narrow network solutions offered by national carriers vs. different models established by newer vendors that focus on a different value proposition and/or does not involve narrowing the network at all.

Description: Take your professional development to the next level, all in one place. Join SOA Board President Dave Dillon and fellow leaders for an inside look at Professional Development Edge+ (PD Edge+), the Society of Actuaries’ comprehensive subscription for continuing education, created by actuaries, for actuaries. Now, in its second year, PD Edge+ is trusted by 88 corporate subscribers to meet their continuing education needs. This webcast is designed for both current subscribers and those exploring what PD Edge+ has to offer. During the session, you’ll see how PD Edge+ simplifies earning CE credits and staying current on industry trends. Don’t miss this opportunity to discover how PD Edge+ can make your learning more engaging, convenient, and impactful.

Description: This three-part series provides an overview of the rapidly evolving and dynamic gene and cellular therapy landscape, from the clinical, historical, and risk transfer perspectives. It covers the actuarial considerations in pricing cell and gene insurance and reinsurance, the value assessment of the therapies, manufacturer pricing, and reinsurance cost.

Description: A look back at 2024, reviewing and highlighting the things that the SOA Health Section Council accomplished, including education, research, webcasts, networking, and a new Health Section Council action plan that will be used on an ongoing basis to target, track, and measure areas of focus for the council, to better serve membership.

Description: A brief review of the 2024 SOA Health Meeting in Baltimore

Description: The coming wave of biosimilars could dramatically affect prescription drug costs and benefit strategies over the next several years. The launch of many Humira biosimilars in 2023 is the Big Event that will largely determine the impact of the biosimilar wave. Payers have many decisions to make about coverage and formulary tiers. What factors will drive payer decision-making?