Description: Increasingly, actuaries need to collaborate and partner with clinicians in order to be successful in value-based care and population health initiatives. Gaining credibility with professionals from different backgrounds, training and sometimes different objectives can be a challenge. Gain perspectives from actuaries and clinicians to discuss how to collaborate and achieve stronger results and outcomes. By attending this session, you will be able to: • Identify common scenarios where actuaries and clinicians need to collaborate. • Understand perspectives on how to partner and communicate with clinicians. • Describe successful strategies that take into account improvement of financial and clinical outcomes. • Understand how actuaries can provide valuable data to drive results and demonstrate outcomes.

Description: The Centers for Medicare and Medicaid Services (CMS) recently released the final 2020 Actuarial Value Calculator and Actuarial Value Calculator Methodology

Description: Discover a comparison of U.S. and international mandated leave programs which mandate employers to provide a minimum level of benefits to employees for qualifying leaves of absence, such as parental leave or medical leave.

Description: The objective of this session is to explore the fast-growing segment of healthcare that is provider enablement. Value-based care (VBC) in its original form was an alignment between providers and payers to deliver on the triple aim of cost of care, experience of care, and health of populations (more recently the quintuple aim including health equity and provider experience).

Description: The world has shrunk and there is no going back. In today’s post-pandemic business landscape, actuaries are frequently being asked to collaborate or lead within multicultural teams dispersed across the globe. The question is, how should companies go about maintaining a sense of team connection across teams that are geographically and demographically different?

Description: As the healthcare industry becomes increasingly complex, actuaries are under pressure to analyze vast amounts of data and make informed decisions quickly. Artificial intelligence (AI) technologies like ChatGPT offer a promising solution, providing powerful tools for data analysis and natural language processing. Come explore the use of ChatGPT in actuarial analysis, focusing on healthcare applications. Begin with an introduction to ChatGPT and how it works, including its ability to understand and generate natural language responses. Then expect a discussion on the potential benefits of using ChatGPT in healthcare actuarial analysis, including improved accuracy, efficiency, and scalability. Through case studies and examples, we will demonstrate how ChatGPT can be used to analyze complex healthcare data sets, including electronic health records (EHRs), claims data, and patient surveys. We will also discuss how ChatGPT can be integrated with other AI tools, such as predictive modeling and machine learning, to enhance actuarial analysis. Finally, learn about some of the potential challenges and limitations of using ChatGPT in actuarial analysis, such as data privacy concerns and the need for human oversight. There will also be guidance on best practices for using ChatGPT in a healthcare actuarial context, including data preparation, model training, and interpretability.

Description: A brief review of the 2024 SOA Health Meeting in Baltimore

Description: This article provides information on the 2025 SOA Health Meeting, including how to submit a proposal, key dates, and other relevant information.

Description: America’s healthcare results are lackluster and worsening despite enormous effort and investment over many decades. Spending, affordability, health, coverage, access, quality, and healthcare workforce results are suboptimal or poor. Too many are suffering, and the system is financially unsustainable. We need a new approach, a new way of thinking about healthcare financing and delivery.

Description: Address issues in value-based contract accounting from an actuarial perspective. In Medicare and ACA business, what issues does risk adjustment present to value-based contract accounting? In Medicare, what issues do Part D present in value-based contract accounting and what are possible solutions? What are the issues in the use of provider stop loss in value-based contract accounting? Are there issues in the timeliness of claims in value-based contract accounting? Are we giving providers enough information for them to manage their population? How do we deal with deficit accounts? What are the pros and cons of capitation, gainshare, and full risk in value-based accounting?