Description: In this session, Deana Bell, FSA MAAA provides a comprehensive introduction to the Medicare Risk adjustment Program. Deana is a Principal & Consulting Actuary in the Seattel office at Milliman. She has been working with Medicare Advantage throughout her career as an actuary. Her expertise includes actuarial opinions, pricing, rating, reserving, medical underwriting, benchmarking, and risk adjustment projects. IN this session she sheds light on how Medicare Advantage health plans are compensated by the Centers of Medicare and Medicaid Services (CMS) through risk adjusted revenue. She highlights the significance of risk adjustment in ensuring financial stability for Medicare Advantage plans. Contributors: Deana Bell, FSA MAAA ; David Koenig, FSA, MAAA, John Dawson, FSA, MAAA, Jon Forster, ASA, MAAA

Description: Discuss various analytics and use cases using payer published reimbursement contract data under federal mandate of Transparency in Coverage. These contract rates are publicly available in machine readable format (MRF) starting July 1, 2022, and refreshed monthly. By attending the session, you will have a better understanding of the state-of-art development and analytics using MRF data, including the technologies used to extract and analyze huge MRF files, validation and limitations of published rates, and their use cases.

Description: In this video, Anthony Champi discusses the non-linear nature of the leadership journey, emphasizing that it involves both successes and failures, and may not necessarily lead to promotions. He highlights the importance of selflessly committing to the development of others if one chooses to become a leader of people, as well as the challenges and responsibilities that come with that role. He also advises individuals to seek opportunities for skill development and learning from mistakes, as well as the transition to leading larger teams or other managers and leaders.

Description: "Discuss research conducted at the Cleveland Clinic to understand levels of anxiety and depression across Northeast Ohio. Specifically, learn how advanced analytical techniques were utilized with social media data from Twitter and Google to estimate the need for psychological support by geography and overtime. The panel will go further to demonstrate how natural language processing (NLP) and machine learning could be used to make operational decisions at a leading health care provider."

Description: In this video Scott Allen, FSA, MAAA discusses the Medicare Advantage Part C bid template. The template helps Medicare Advantage plans estimate costs and premiums, comparing their bids to CMS benchmarks. It’s a complex process involving worksheets that project costs, calculate revenue requirements, and determine rebates, ultimately influencing the plan’s benefits, premiums, and competitiveness in the market. Contributors: Scott Allen, FSA, MAAA, Eric Milner, ASA, MAAA, Danica Turner, FSA, MAAA, Jon Forster ASA, MAAA

Description: This session will be centered around the roles and responsibilities of a valuation actuary. Learn the best practices of health actuaries, along with technical considerations and professionalism issues surrounding the calculation and reporting of health liabilities and reserves. This session will focus on key actuarial liability and reserve provisions, including Claims Unpaid and Premium Deficiency Reserves. In this session, explore new ideas about calculation methods and the importance of the underlying assumptions. You will also learn best practices and practical applications concerning reserve calculation discuss best practices regarding the preparation of an actuarial memorandum supporting a Health Annual Statement. This will include key considerations from the American Academy of Actuaries' Practice Note about documenting and supporting the actuarial calculations. The discussion will also present views and considerations from both the insurer's and the regulator's perspectives.

Description: Climate change will lead to an increase in the frequency and severity of many weather-related hazards. In turn, these hazards will impact health outcomes for individuals. Explore examples of this connection with a climate scientist, including how the increase in wildfire severity in the western U.S. is expected to drive a 40% increase in organic carbon aerosols by 2050 and howheat stress will impact vulnerable populations and workers in non-air-conditioned environments. Investigating these relationships will increase literacy on disproportionate impacts of climate change-related health outcomes. Presenters will illustrate the disproportionate impacts by geographically analyzing climate change signals and comparing them with socioeconomic data. Last but not least, you will learn about the evolution in both voluntary and required disclosures for payors and the landscape of why understanding climate risk is relevant for many payors.

Description: Delves into the impact of rising interest rates on annuity product management, with a focus on the challenges of disintermediation and implications to hedging. Learn about in-force management actions, best practices for managing annuities in a changing environment and associated risks. Explore how companies are revising their hedging strategies to adapt to shifting market conditions and regulatory framework changes. Gain a comprehensive understanding of the relation between rising interest rates and disintermediation, its financial and business impacts, and strategies for managing business and setting assumptions during periods of high disintermediation. Come away with practical strategies for optimizing returns, minimizing risks, and navigating the challenges and opportunities associated with annuity product management in the current interest rate environment.

Description: Since the Affordable Care Act implemented minimum loss ratio provisions for health plans, several states have passed or at least considered minimum loss ratio regulation for dental plans. While such regulations are intended to improve insurer efficiency and promote value to consumers, they can have unintended negative consequences if the unique characteristics of the dental insurance market are not considered. Learn about this hot topic, including loss ratio basics, recent legislative activity in the dental loss ratio space, how dental differs from medical, and why those differences are critical to account for when trying to regulate loss ratios in that market.

Description: In this panel discussion, actuarial leaders in the stop-loss marketplace provide their perspectives on recent stop-loss trends. Learn about the most current issues facing self-funded plans and their stop-loss coverage. Take part in a deeper discussion on this topic and more at Oysters, Beers & Large Claim Solutions on Tuesday, June 27, from 4:30-5:30 p.m. PT. This happy hour, featuring drinks and tasty Pacific Northwest oysters will include a discussion on the large claims impacts on the health care market.