Description: The Health Care Cost Institute (HCCI) recently released their annual health care cost and utilization report on February 13, 2020. This report illustrates employer group commercial health care costs and trends from 2014 – 2018.

Description: Description of the design and purpose of the military health system and Veterans Health Administration's programs. Covers the types of benefits offered and how these programs differ from typical commercial health systems.

Description: In this Society of Actuaries (SOA) Research Institute report, authored by consultants from Milliman, Inc. (Milliman) we aim to study the effects of hurricanes on human health: whether there is a relationship between hurricanes and the observed prevalence of healthcare utilization or certain health conditions among the affected population, whether this relationship can be observed through a healthcare utilization dataset, and whether there is an interaction between this observation and metrics of socioeconomic vulnerability.

Description: An update of selected key graphs from the Key Statistics section of previous COVID-19 briefs.

Description: Dealing with more known unknowns? More scary knowns? Or unknown unknowns? What is the next unthinkable? What future events should actuaries actively be modelling and keep us up at night? The Catastrophe & Climate Strategic Research Program of the Society of Actuaries Research Institute (SOA) put forth a call for essays exploring these risks. The Program Steering Committee selected these essays submitted by Sam Gutterman and Max Rudolph to publish, and are awarding them each a prize of $500. The Catastrophe & Climate Strategic Research Program Steering Committee congratulates the authors and is happy to publish the winning essays on the SOA website.

Description: Listen to this discussion on a variety of subjects related to disability reserving (e.g. runoff analysis, estimating SSDI offsets). Case studies will be used to examine the potential impact of different approaches to these assumptions and experience studies on reserve estimates.

Description: Cell and Gene Therapy (CGT) are life-changing treatments where conditions such as cancer, hemophilia, spinal muscular atrophy and blindness are being cured. These are great for individuals and society, but the treatment costs are expensive which is bad for payers and reinsurers. This article explores ways for health reinsurance actuaries to participate in the space and evaluate the risk associated with these treatments

Description: The big event of 2023 is the launch of multiple Humira biosimilars, which began in January with the arrival of Amgen’s Amjevita on the market. The launch of Amjevita kicks off the process of changing the specialty drug marketplace in the United States. The expectation of the full impact of this big event is very hopeful, but there is still uncertainty several months after its beginning. Humira is the highest-selling drug in the world and has been since 2013 (Figure 1)—except for when COVID-19 projects temporarily surpassed it. The world is eagerly awaiting the launch of multiple biosimilar drugs to compete with Humira and hopefully bring more competitive pricing to the benefit of payers and patients everywhere.

Description: Medicare Advantage Organizations (MAOs) have made dramatic changes to the benefits and plan premiums they've offered members over the past years. Hear about information on the changes to benefits and plan premiums offered over the past few years. Find out where these strategic items are currently (for CY2024 bid year) and get ideas on what might come in the next few years. Presenters will discuss recent proposals and rules from CMS that will impact the current and future landscape. They will also compare these items in relation to the fee-for-service (FFS) Medicare market. This session will help you gain a deeper knowledge of the Medicare Advantage, Prescription Drug Plan, and Medicare FFS landscape and walk away with some strategic thoughts on potential paths MAOs may take from here.

Description: Discuss the dramatically changing provider landscape, as well as the innovative solutions being leveraged by providers to address the intriguing opportunities and complex challenges. Among the questions to be answered are the following: How can providers capitalize on employers’ desire to contract directly with local providers? What's the path for providers to develop employer stop-loss (ESL) capabilities to maximize network value/impact? Can providers create a risk portfolio including ESL for local employers, their own employee plan, and other delegated risk arrangements such as Medicare Advantage? How can captive insurers support a provider's risk strategy?