Description: The evolving specialty pharmacy environment has created difficulties for actuaries pricing and forecasting pharmacy coverage. Unpredictable specialty pharmacy trends have increased insurers' earnings volatility and affected members' health care affordability. The presenters will highlight the current specialty drug development pipeline and explore specialty pharmacy drug trend management strategies. They will also provide concepts to help manage the coming wave of gene and cell therapies.

Description: Reunite with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, IFRS 17, product strategy, cross-border communication and discussion, and more. Advance your career through learning and networking opportunities, and share your experiences in the finance and insurance industries, as well as other fields related to actuarial science.

Description: Explore the value and cost of prescription drugs, how they should be defined and measured and the effects various stakeholders in the pharmacy ecosystem can have on these factors in the latest webcast. You'll investigate the impact of coverage, formulary and rebate negotiations and related benefit design. Find out how actuaries can answer questions related to the prescription drug industry, in addition to improving the access, quality and affordability of prescription drugs in the United States. Join us for this webcast and come learn about value-based contract design, negotiations, implementation and administration for prescription drugs.

Description: This report is a discussion of the significant challenges involved in attempting to research with robust analysis the impact of disparities in health care access, cost and quality of care on financial wellness across racial, ethnic, socioeconomic and other demographic groups in the U.S. for reasons other than or in addition to income, wealth or employment status.

Description: Guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting.

Description: The instructors in this boot camp session will highlight the SOA's work on an updated Medicaid underwriting margin model. This research project includes an excel model, a set of instructions and a paper describing the key components of underwriting margin, including cost of capital and risk margin.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.

Description: Gather with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, pension, investment, product strategy, and more.

Description: On September 14, 2022, The Wall Street Journal hosted its ‘Future of Health’ event, which was a virtual event featuring three sessions on some emerging cutting-edge topics that could impact the future healthcare environment as well as health care actuaries. This report summarizes the event.