Description: Develop a better understanding of specialty drug trends and their increasing healthcare costs for more than the past decade by attending this webcast. With the introduction of price competition, you will see changes in the market for biosimilar products and patent-protected drugs. For example, the drug Humira will be gaining 10 biosimilar competitors in 2023. Alone, Humira can represent over 20% of total pharmacy spend for health plans. Join us and discover how price competition is a turning point for the pharmaceutical industry and will define its direction for the next decade.

Description: Hear highlights from recently published and upcoming Society of Actuary (SOA) Research Institute reports, Including work on specialty pharmacy and the long-term impacts of COVID-19. Join us as we focus on the financial impacts of these issues as well as trends and other actuarial considerations.

Description: Join us as we explore how recent innovations & future changes in the American worksite will impact the future of the Critical Illness product

Description: CMS launched the value-based insurance design (VBID) model in 2017, allowing health plans to offer innovative supplemental benefits and incentives to beneficiaries to use high-value services specific to their health care needs or socioeconomic position. CMS's stated goal is to encourage health plans to implement strategies that focus on health equity. The model has evolved over time and has grown tremendously in popularity over the years since it was introduced.

Description: Every patient leaving the hospital has personal life-context circumstances that impact their chances of successful recovery and complications can be costly. Complex care management impacts over 50 percent of health care spend, with the admitted commercial population driving 37 percent of spend or $177M per 100,000 lives and the Medicare population driving 53 percent of spend or $600 million per 100,000 lives. The stakes are high, but existing care management solutions are mostly clinical and navigation call centers provide fragmented and outdated patient management systems, and do not address individual life-context. Discharged patients therefore remain underengaged and undercompliant, leading to costly complications. Innovative technology can help enable and integrate systems and existing infrastructure to leverage evidence-based contextualized care that will enhance care management, improve efficiency, and drive a better experience and outcomes for patients. This technology helps codifies life context, dynamically stratifying and engaging members digitally and telephonically helping virtual care teams to be more effective and efficient. In a recent randomized clinical trial, this technology and approach has shown a 50 percent reduction in the total cost of care, cutting the average and total cost of readmission, increasing virtual care team impact and member engagement and trust.

Description: As more gene and cell therapies enter the market at increasingly higher price points, they are ushering in a new era of medicine for rare diseases. Unlike most traditional therapies, gene and cell therapies typically have a short or one-time treatment administration and are anticipated to provide long-term clinical benefits. Actuaries must be prepared to assess, manage, and/or mitigate the risks associated with these therapies. This session includes three different perspectives—a regional plan, a stop loss/reinsurance carrier, and a health care consultant.

Description: Much of the work performed by disability insurance actuaries depends on the availability of accurate and detailed data, which is not always as simple as it sounds. Explore a variety of data challenges faced by disability actuaries, along with potential solutions. Potential topics include finding relevant data, the impact of poor data on valuation work, the impact of new privacy rules, and the potential bias in the data used to develop predictive models.

Description: Explore historical trends in enrollment, carrier participation, and competition over the first 10 years of the individual marketplace as a basis to frame what the future could hold for the next 10 years. Draw parallels to other lines of business (e.g., Medicare Advantage, employer group) as we look at how the market may evolve and the capabilities required to succeed. This session would be valuable for anyone interested in consumer purchasing behavior, quality and risk adjustment, employer benefits, provider dynamics, and the individual market more broadly. By attending this this session, you will be able to articulate the impact of recent legislation and regulatory actions on the Individual market, including subsidies, employer funding vehicles (e.g., ICHRA), distribution channels, and product requirements.

Description: Management service organizations (MSOs) in value-based care have expanded into far more locations in the health care ecosystem; some demonstrate value to both buyers and providers. Explore the role of these players in the health care ecosystem, their future outlook, and how actuaries can help them perform.

Description: In today's growing supplemental health space, innovative benefit offerings are essential for both marketability and market competition. Discuss the latest trends in accident, critical illness, and hospital indemnity plan design, as well as the regulatory hurdles that can be involved when implementing these new benefits.