Description: The presenters will provide updates on research being conducted under SOA sponsorship. This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes.

Description: A review of strategies for non-ACA products for small employers including level-funded plans, association health plans (AHPs), and multiple employer welfare arrangements (MEWAs). Discussion will focus on market trends, strategy, pricing, and block management. Session will include some audience participation via polling so audience can crowd source information and identify industry trends.

Description: In this session we will discuss the impact of regulation changes that will allow members with End State Renal Disease (ESRD) to sign up for Medicare Advantage in 2021 for the first time. We will delve into the current basics of how ESRD works, the characteristics of the population that is currently on original medicare today, and a comprehensive look at what plan sponsors should be thinking about going into 2021.

Description: Insurance commissioners and deputy insurance commissioners will discuss current topics including health care reform, life insurance issues, risks in the major medical markets, voluntary products and other topics.

Description: The presenters will discuss the range of draft repeal/repair/replace legislation proposed to date, the elements most likely to be included in the final law, and possible temporary and transitional measures to be taken. They will share their findings regarding the impact on the industry of these changes using the most up to date data and modeling available.

Description: The always popular Medicaid Hot Topics session is back with discussions from an expert panel on the most riveting Medicaid topics of the year. These could include the following: • Medicaid Fiscal Accountability Proposed Regulations• Tennessee's Block Grant Proposal• ACA court battles: What are the potential impacts on Medicaid? • Pass-through payments are converting to directed payments: What is changing?• And more current topics of interest to Medicaid actuariesMedicaid is dynamic and it is difficult to stay current on all of the changes. This session provides insightful discussion into the major changes that impact actuaries and their companies or state clients.

Description: Intended for actuaries interested in understanding more about the Medical Loss Ratio and the impact Quality Improving Activities (QIA) and fraud reduction expenses have on the rebate calculation. This session will focus on what expenses qualifies as QIA, examples of programs from major carriers, current regulations and the differences between commercial, and Medicare, and Medicaid requirements.

Description: Dental care is an important component of everyone's health, and senior citizens are no exception. With no public dental coverage under traditional Medicare, seniors must seek other ways to obtain dental insurance, pay for services out of pocket, or go without care. In this session we will review the importance of oral care to overall health, the current state of public and private dental insurance for seniors, and innovative ways to reach this population. Medicare, Medicare Advantage, Medicaid, and other types of dental coverage will be discussed by three actuaries with different areas of expertise in the senior dental market.

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

Description: Health care is a complex market with a wide variety of stakeholders. These stakeholders have diverse business needs, requiring complicated data-driven decisions. The analytics and research supporting these decisions are often dependent on the availability of real-world data (RWD), which includes a wide variety of data capture technology and data reflecting treatment, clinical outcomes, and costs of health care in real treatment settings (e.g.,, outside of controlled clinical trials). The goal of this panel discussion is to explore how existing and emerging sources of RWD can enhance benefit design, improve risk assessment, influence treatment decisions, and advance the measurement of clinical, humanistic, and financial outcomes. The diverse speaker panel includes actuarial and non-actuarial perspectives, representing the pharmaceutical industry, a health-care services business, and academia. The panel will describe the decision-making that drives their individual needs to use RWD, identify current and developing RWD sources, provide examples of analyses using RWD, and discuss how emerging RWD may influence actuarial analytics and potentiate the development of new interdisciplinary methods and value drivers.