Description: State Medicaid programs have broad flexibility to establish their own payment methodologies and rates for hospital services. Many states direct additional funding to populations, services, and hospitals where Medicaid comprises a disproportionate share of total business, or where there are other access concerns (e.g. rural providers). Actuaries can play a key role in determining where those additional funds would have the most benefit.

Description: A diverse panel of health actuaries will be available to answer any attendee questions. An ACA question, we have it covered! A valuation question, we will find a solution. A professionalism issue, we will make a ruling! A regulatory concern, we will help guide the way!! No question is off limits! There are no stupid questions!

Description: Delve into the factors contributing to the rapid growth of high-cost medical treatments and how payers can manage the financial exposure that comes with them. Learn about the current and near-future state of million-dollar medical costs, as well as the trends shaping the industry. By attending the session, you will have a better understanding of the underlying drivers of high-cost treatments and will be equipped with practical strategies for mitigating their financial impact, including risk management techniques, cost containment measures, and new payment models. Additionally, you will be able to identify key considerations for implementing these strategies in their own organizations.

Description: The Inflation Reduction Act represents the largest change to the Medicare Part D program since its inception in 2006. With a complete redesign of the Part D program coming in 2025 (the next bid cycle), there are health plan, operational and analytical challenges that lie ahead. In this session, you will: Hear highlights on some of the key changes occurring in 2025 Learn about key considerations for health plans and other stakeholders in the Medicare and commercial markets Discover potential winning strategies and potential analyses that could inform those strategies

Description: Learn more about Health Care Sharing Ministries (HCSMs) and their functionality as health insurance. These nonprofit companies pool money from participating members to assist with members' healthcare coverage. Further exploring HCSMs, some of the offered arrangements of this plan operate differently and with a unique regulatory framework. HCSM enrollment has grown 1000% since solidification as a law in the ACA. By signing up for this webcast, you can discover why HCSMs are becoming a key component of the individual market in some states.

Description: This session will focus on the latest regulatory changes impacting commercial dental plans, including recent developments in Minimum Loss Ratio Requirements (MLR) and the potential inclusion of adult dental services as an Essential Health Benefit (EHB).

Description: The Tri-Agency published the final rule on short-term limited duration insurance and fixed indemnity coverage at the beginning of April. We’ll break down the new rule, approaches to complying with the new requirements, and what implications it could have for the supplemental health market moving forward.

Description: The cell and gene therapy marketplace is quickly evolving and continues to grow as a risk concern for governments, health plans, stop loss insurers and reinsurers. In this webinar, we discuss currently approved tissue, cell and gene therapies, the near-term pipeline, uptake considerations, case management processes, plan document and contract considerations, risk mitigation processes and programs, and network considerations.

Description: Hear an overview of recent results and potential scenarios that may impact the future of the ACA market. Review recent reported industry level profitability before transitioning to a discussion of how current market dynamics may influence the future profitability of this segment. Results from microsimulation economic models will be presented to help illuminate market shifts. Issues that will be explored include how ICRA availability might influence individual decision making, as well as how a move to level funding is impacting the small group market.

Description: Explore the findings from the research paper recently released by Milliman and the SOA, highlighting the growing need for support of informal/family caregivers. We will discuss both quantitative and qualitative data that illustrates not only the cost and burgeoning need, but the mental/emotional stressors that come along with this work.