Description: Risk adjustment is widely used by public and private payers in value-based contracting and other risk-sharing arrangements aimed at addressing population health. Addressing social determinants of health (SDOH) and improving equitable outcomes is one of the aims of population health. Could SDOH be incorporated into risk adjustment? If so, how and how effectively? What implications might this have for market participants? In this session, Joan Barret, FSA, MAAA, from Axene Health Partners will begin by presenting background and findings from the 2022 SOA research report 'How Does Where you Live Impact Your Health?.' This is a question addressed through deep literature review and quantitative analysis, followed by an exploration of strategic approaches and barriers for payers and providers that wish to address SDOH inequities. Then, Rong Yi, FSA, MAAA, and Jeff Milton-Hall, FSA, MAAA, from Milliman will present their new SOA-sponsored analysis regarding integration of SDOH factors into Medicaid managed care risk adjustment. They will cover risk adjustment design considerations, policy and operational considerations for actuaries and states that wish to integrate SDOH into risk adjustment, simulated variation in financial outcomes for risk-bearing organizations when such integration occurs, and variation in the relationship of SDOH factors and morbidity to modeled risk across programs and populations. At the conclusion of the session, attendees will leave equipped to think critically and act effectively with respect to SDOH in their own work, from measurement and analysis design to actuarial interventions.

Description: This session will showcase how from an actuarial perspective IFRS17 has its roots in market consistent valuations. It will also show how International Financial Reporting Standard (IFRS) 17 is rooted in probability-weighted stochastic scenarios-same as fair valuation, and how initial recognition sets the stage, as in the pricing basis and report, for actual experience to emerge as in the subsequent recognition. A detailed model will be given for a simple annual premium non-par endowment and actual numbers given and explained. The stochastic model will explain in detail the key reserve items in IFRS 17 including: - Liability for remaining coverage (LRC) - Risk Adjustment (RA) - Contractual Service Margin (CSM) And it will explain their interactions with one another. A discussion will be held regarding universal life policies with simple interest guarantees. And how these guarantees merit a valuation similar to Lookback options because of their path-dependent nature.

Description: Runtime of actuarial models and their associated processes has been a growing concern amongst the industry. This session will explore how expanding regulatory requirements, refined analytical objectives, and the desire for process optimization have increased the amount of processing power needed to get answers in a timely manner. Presenters will dive into how companies are leveraging data, refined pre- and post-processing routines, runtime reduction techniques, and cloud-based solutions to increase their efficiency in producing, analyzing, and validating model results.

Description: The insurance industry is faced with many unforeseen changes such as recent advances in technologies and the associated impacts on the risk assessments. In this session, we focus on two specific developments; (i) the liquidity provision problem on automated market makers (a.k.a. DeFi exchanges such as Uniswap) and the conditions under which liquidity providers should enter or exit the DeFi token pools; and (ii) efficient utilization of drivers telematics data for better risk classification in personal auto insurance.

Description: Building new models or migrating from one system to another is hard! During this session, you will hear from your colleagues who have gone through such projects. You will gain a better sense of what to expect, what to avoid, and what to prioritize for such projects. The discussion will be system agnostic. Learn about pitfalls and how to avoid them!

Description: Session 5A: Creating Continuity in Behavioral Health for Medicaid & ACA Beneficiaries

Description: This session includes a new idea based on dynamic treatment regime work (OWL) and integrating cost into this work. This will enable identifying the best treatment for a patient based on both outcomes and cost. This is novel for actuaries because in previous analysis we have used cost only in the after-analysis, whereas here we use it in the actual analysis and treatment identification. Moreover, this analysis provides a way to consider multiple treatments for a patient (including the no treatment option) and choosing among those multiple treatments, for both outcomes and cost. This session will share the background theory and set up a case study. The case study will parallel what is in the analysis in the book by Ian Duncan 'Predicting Hospital Readmission with Case Management Recommendation.' This analysis will then go further to compare a situation where there are multiple potential case managers. Also, this will potentially explore care pathways and choosing the best care pathway for a patient based on health outcomes and cost combined.

Description: The expanded use of predictive models, algorithms and external consumer data has drawn the attention of the life insurance industry to the matter of fairness and bias in underwriting, including proposed regulation in states like Colorado and New York and a draft NAIC Model Bulletin. Insurers will benefit taking a proactive approach to verifying that their practices, both current and future, do not result in unfair discrimination. This session will help attendees in understanding potential requirements and reporting insurers must address, techniques and tools for evaluating bias, and challenges in doing so. At the conclusion of the session, attendees will be able to: o Understand proposed regulations and practices regarding fairness and bias o Identify tools and techniques for evaluating bias in their processes o Discuss the challenges the industry will face in addressing fairness in underwriting

Description: "A crucial importance in forecasting is to be able to distinguish cases when temporary slowdowns in health care utilization are followed by a “rebound” period of higher utilization. Come explore an analysis of a new mathematical model describing the return-of-care process. By means of simulation and case studies using the R programming language, the relationship between the visibility of these effects and the endogenous variance of the utilization time series is explored. After attending this session, you will be able to: Describe the parameters and mathematical form of the model Apply the model to real-world utilization data"

Description: It goes without saying that the analysis of data is a key aspect of actuarial practice, but do traditional actuarial approaches allow us to see the whole picture? Effective data analysis is also key to the identification of health disparities and measuring progress on health equity. Actuaries and others analyzing data for health equity purposes find themselves looking at data differently.