Description: Listen to pre-eminent healthcare actuaries present their pitch for how they'd fix US healthcare (whatever the pitch thinks 'fix' means) if they were supreme policy maker for a day. No idea is too big, and no healthcare actuary's dream is too small.

Description: Attendees will learn what the Health Equity Index is, how it will be calculated, how it affects quality and Star metrics for Medicare Advantage plans, and how this could change the industry as a whole moving forward.

Description: This session will be centered around the roles and responsibilities of a valuation actuary. Learn the best practices of health actuaries, along with technical considerations and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. This session will focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. In this session, explore new ideas about calculation methods and the importance of the underlying assumptions. You will also learn best practices and practical applications concerning reserve calculation discuss best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement. This will include key considerations from the American Academy of Actuaries' Practice Note about documenting and supporting the actuarial calculations. The discussion will also present views and considerations from both the insurer's and the regulator's perspectives.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

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: 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: "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: Session 4E: Sometimes The Second is Better than the First - Round 2 for the ACA

Description: The Medicare Advantage (MA) program is facing challenges in the coming years due to a number of headwinds: Star rating program changes, the Inflation Reduction Act (IRA), revenue pressures, mergers/acquisitions, and risk score model changes, just to name a few.

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.