Description: Value-based care models have to date been focused on either broad, total-cost-of-care, primary care-based models; or on a limited set of episodes of care. This session will focus on initiatives to bring these concepts together for improved outcomes for patients and greater savings from an integrated solution.

Description: This session is intended to provide an update on past, current, and future studies done by the SOA GLTD Experience Committee. This includes an update on the ongoing Group LTD Incidence Survey including the nature of the study, goals, timelines, data submissions, and current status.

Description: As health insurance self-funding becomes more popular among smaller group sizes, risk is evolving for the MGUs, stop loss writers, and reinsurers that cover them. Assessing more small groups at lower attachment points means rethinking traditional stop loss underwriting techniques.

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

Description: Our panel of experts will explore 'Blue Zone' communities, the common denominators slowing the aging process and the potential impacts these initiatives could have on disability and long-term care insurance.

Description: The document provides information on the ACA@15 research project, focusing on the extent that the Affordable Care Act legislation was able to meet its stated goals of reducing the uninsured rate, increasing coverage options, and providing affordable health insurance. It includes research findings, objectives, and key takeaways.

Description: "Risk adjustment is an important aspect of establishing appropriate capitation rates. When a set of services is carved out for specific management under a sub-capitation, establishing appropriate adjustments for varying levels of underlying risk is more complicated. Dive into analytical and operational challenges and resolutions as presenters share more about developing a risk adjustment model specific to the carve-out of behavioral health services through a real-life case study. You will further explore a definition of the use case, availability of historical data sets, selection of the modeling approach, learnings from the iterative modeling process, and the potential application of the results. After attending this session, you will be able to: Understand why a behavioral health specific-risk adjustment model has business value Understand the unique challenges related to developing risk adjustment on member and cost subsegments Understand the impact of trade-offs between model complexity and interpretability in the context of implementation Increase awareness of data nuances and requirements unique to this type of project Describe analytic techniques that can be investigated for use in projects of similar business objectives"

Description: Discuss changes in group life waiver of premium claim recovery and mortality experience since the 2005 table was released, the development of the 2023 table, and the new statutory valuation standard approved by the National Association of Insurance Commissioners (NAIC).

Description: While states face a wide variety of circumstances and have implemented diverse approaches to the MOE phase-out, we revisit the conversation to discuss emerging experience across stakeholders as we examine the operationalization of the PHE unwinding as it relates to this major disruptor in the distribution of the healthcare enrollment.

Description: A priori, one would expect In Home Assessments (IHA) and Telehealth (TH) Encounters to identify some conditions that lead to actions that keep a member or two out of the Emergency Room. Similarly, one would expect Care Management and Disease Management engagement to ultimately influence some improvement in documentation that leads to more accurate Risk Adjustment. The business cases for these activities are often siloed to only the primary activity. The relationship between risk adjustment and care management is often more recognized as competing interests - one generally relying on utilization and the other trying to reduce it. Business cases can change dramatically when profiling has a more complete picture. This session will explore some techniques and share some observations - positive and negative - of the interactions between CoC and Risk Adjustment.