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. By attending this session, you will: Understand the recent average and variation of industry performance in the ACA market segment. Describe current policy and market forces that are expected to impact this segment. Explain the range of market scenarios that may result due to these forces."

Description: With the mandated health plan transparency files, health plans and providers are now able to substantially enhance their provider contracting efforts. Although the files are large and cumbersome they are market disruptors and provide new insights for provider contracting efforts. Explore a demonstration on the type of information now available and how it can be used to enhance this from both a health plan and health care provider perspective.

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: This topic will explore current and upcoming changes to the risk adjustment models and strategies for payers and risk bearing providers to reduce/avoid headwinds and potentially come out on top in the years ahead. We will discuss the timeline, nature and motivation for changes as well as the anticipated associated impacts.

Description: The world has shrunk and there is no going back. In today’s post-pandemic business landscape, actuaries are frequently being asked to collaborate or lead within multicultural teams dispersed across the globe. The question is, how should companies go about maintaining a sense of team connection across teams that are geographically and demographically different?

Description: Join us as we explore Medigap claims assumptions and more. What has been driving cost increases? Does the trend vary by market? How are area factors determined? What opportunities exist for niche carriers? This session will provide a fresh experience-based perspective on key pricing considerations and leave you with food for thought as you manage your business.

Description: After 10 years, the Affordable Care Act (ACA) risk adjustment program has evolved as the ACA has evolved. In recent years the Centers for Medicare and Medicaid Services (CMS) has focused on predictive accuracy over compensating for actuarial risk and has failed to address systemic issues such as insolvencies that created suboptimal outcomes for the ACA markets.

Description: How is extreme weather impacting you? If you live in California, you may have been impacted by the atmospheric rivers unleashing record-breaking rain and snow last winter. If you live in Canada or near Canada, you may have been impacted by the wildfires raging last spring. NASA has declared that the summer of 2023 was the hottest on record.

Description: In this session, we will provide examples and highlight real-world analytics that have been done to compare providers of tertiary and quaternary (T/Q) services (i.e., complex and potentially rare conditions). We also will address the need for analytics like this, who the potential audiences are, the data necessary to complete an analysis, and we will walk through actual case studies.

Description: The presenters will discuss current focuses in behavioral healthcare (MH/SUD). This may include cost and utilization trends, access to care, modalities of care (e.g., telehealth, app-based solutions, etc.), and other hot topics. The attendees will hear perspectives related to the overall landscape of behavioral healthcare in the US and how that impacts actuaries.