Description: Health care has changed rapidly over the past couple of years. The pandemic has shifted consumer behavior in how and where they receive health care as well as consumer attitudes toward health care. Payers continue to design innovative solutions in responses to their patient’s needs and expectations. These changes in consumer behaviors and the responses by payers are expected to impact both health care cost and utilization. Discuss changes in health care that have emerged due to the pandemic and how they are expected to influence actuarial assumptions. Explore epidemiological models commonly used in the industry, the considerations when using these models, as well as the challenges with regards to gathering and interpreting relevant experience data. By attending this session, you will be able to: Identify shifts in consumer behavior that have emerged from the pandemic and describe how payers are responding to new patient expectations. Discuss how these post-pandemic changes by consumers and payers influence medical spending. Determine which actuarial assumptions are impacted and how and if the impact is expected to be temporary or permanent. Discuss considerations taken by actuaries and challenges faced when modelling actuarial assumptions post pandemic.

Description: With the mandated health plan transparency files, health plans and providers are now able to substantially enhance their provider contracting efforts. Although the files are large and cumbersome they are market disruptors and provide new insights for provider contracting efforts. Explore a demonstration on the type of information now available and how it can be used to enhance this from both a health plan and health care provider perspective.

Description: In this session, we will provide examples and highlight real-world analytics that have been done to compare providers of tertiary and quaternary (T/Q) services (i.e., complex and potentially rare conditions). We also will address the need for analytics like this, who the potential audiences are, the data necessary to complete an analysis, and we will walk through actual case studies.

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: In this session, we will delve into the application of survey data analytics to extract valuable insights from public survey datasets. The discussion will start with the basics of survey design, sampling practices, and estimation of key statistics. Three case studies will be presented: one in the realm of population health and another in medical economics, both demonstrating the use of either SAS or R to perform the survey analytics.

Description: Join in and learn to describe the changes in provider contracting that are emerging in the post-COVID marketplace. Examples include: - Carrier transparency files - Increase sophistication of provider negotiators - Additional sources of data - Market issues increasing urgency - Demanding new contracting models