Description: Session 2D: Thinking Local - The ‘Oh Wows’, and 'Oh Nos' of Medicare Advantage for Regional Plans

Description: Plan Sponsor Perspective

Description: This session will review the latest developments in the Affordable Care Act (ACA) marketplace, including a discussion of hot topics, challenges, and opportunities on the horizon. Specific topics will include cost-sharing reductions (CSR) loading and the impact on subsidized rates across states (e.g., mandated loading in NM), the interaction of American Rescue Plan (ARP) subsidy expansion, and the impact on ARP-enhanced subsidies end.

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.

Description: This session will review the latest developments in the Affordable Care Act (ACA) marketplace, including a discussion of hot topics, challenges, and opportunities on the horizon. Specific topics will include cost-sharing reductions (CSR) loading and the impact on subsidized rates across states (e.g., mandated loading in NM), the interaction of American Rescue Plan (ARP) subsidy expansion, and the impact once ARP-enhanced subsidies end.

Description: Patients with chronic conditions such as musculoskeletal pain, diabetes, and hypertension impact 50% of the US healthcare population, consume more than 85% of healthcare costs, and often require a higher volume of care, expensive imaging, testing, and emergency procedures, and long-term high-cost drugs. Managing these conditions through innovative digital health interventions provides a significant opportunity for higher-touch and more-effective management that will result in lower costs.

Description: In this session, we will review how the previous and current concerns of pharmacy actuaries will affect the forecasting and review of upcoming pipeline events. After this session, attendees will have a broader understanding of the implications of what is coming next in the pharmacy pipeline and how they can be thinking about it.

Description: This session will cover emerging topics in the individual disability insurance (IDI) market. These topics include a discussion of disabled life mortality and recovery experience, an update from the SOA Individual Disability Experience Committee, and a preliminary glimpse at 2023 IDI sales experience. Attendees will gain an understanding of the latest trends in this complex market.

Description: Inspired by Seinfeld's Festivus celebration, our panel will conduct a lighthearted but technically robust airing of grievances related to the Medicare Star Rating program. Over the past decade, the Medicare Star Rating program has undergone an array of methodological changes.

Description: Discover the multitude of risk transfer solutions and payment models available to health claims payers for cell & gene therapies in this Society of Actuaries webinar. Delving deeper into the topic, we will examine the different types of solutions, weigh their pros and cons, and explore the future prospects of this rapidly evolving area of the healthcare landscape. By expanding upon the pricing and risk exposure discussion from session two, this webinar provides valuable insights into the dynamic market for cell & gene therapies and its implications for actuaries.