Description: Renal disease is a very heterogenous medical condition whose end state is dialysis, a recurring cost intensive medical condition. Dialysis cost is one of the major medical cost drivers in USA. Insufficient and improper care management in the early stages of CKD (chronic kidney disease) leads to early incidence of end stage renal disease (ESRD) among CKD patients which not only leads to high medical costs, but also reflects poor health quality.

Description: Almost half of recent FDA approvals have been for orphan drugs. This trend is expected to continue in 2023. Orphan drugs are priced more than 30 times higher than non-orphan drugs, therefore their cost burden in aggregate has the potential to overwhelm the budgets of payers, especially that of smaller health plans. Hear how the cost impact analysis for smaller health plans require different considerations than for a larger health plan when modeling the impact of rare diseases.

Description: The global doubling of information content has been estimated to occur at a rate of every 12 hours, and conceivably faster. This ‘infowhelm’ is a double-edged sword for insurers. While maximization of the global knowledge base can fuel innovation, it can occur only in the context of reasonable cost for a higher benefit. The insurance industry – underwriters and actuaries in particular – are challenged to constantly examine new innovations that promise to raise confidence and protective value for insurability, within legal limits. This report aims to be the first of several to alert the SOA of promising innovations for the profession.

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, attendees will understand the role of AI in risk management and underwriting. You will see insightful case studies highlighting AI-driven techniques for enhancing precision and efficiency in these areas. Additionally, the session will cover advanced AI applications in claim management and fraud detection, showcasing cutting-edge strategies to mitigate risks and streamline operations.