Description: The Centers for Medicare and Medicaid Services (CMS) implemented significant changes to the Medicare Star Ratings that are expected to result in cost savings to CMS. The 2024 Star Ratings were recently released in October 2023 which was the beginning of these changes where future changes will impact 2026 and 2027 Star Ratings.

Description: Come check out a diverse panel of health actuaries available to help guide you around the track for any question you may have. An ACA question - we have it covered! A valuation question - we will find a solution. A professionalism issue - we will make a ruling! A regulatory concern - we will help guide the way! No question is off limits! There are no stupid questions!

Description: Investigate the importance of collaboration with accounting, underwriting, sales, marketing and other professions as an actuary when you attend this webcast. Cross-functional positions can cause unique challenges to arise, like various experts attempting to balance growth and profitability. Discover an opportunity to learn about relevant ASOPs and dive deeper into contemporary examples that highlight specific professionalism issues that can develop.

Description: Do your interests stop at your actuarial responsibilities of risk analysis, trend and rate submission? Reach beyond your role as the actuary. Become a leader-manager within the Market Segment Team and a trusted advisor to the P&L leader. Choosing your approach to working with the P&L leader determines your influence and impact on segment sustainability and success

Description: You will be reminded how to spot and avoid statistical biases and fallacies that are common to health care actuarial data and problems. We plan to explain various statistical biases and fallacies and for each show one or two examples of how they might pop up in healthcare data and what strategies can be used to avoid/account for them. Likely topics include simpson's paradox, regression to the mean, base rate fallacy, sampling bias, survivor bias, Berkson's fallacy, and others.

Description: This session will include examples of healthcare claims and market data to be used for educational purposes to highlight trends in the insurance industry. It will also highlight opportunities to enforce existing laws around fraud and abuse, and areas for regulators and legislators to focus to address this growing problem. Finally, it will discuss recent law changes and highlight areas requiring additional regulatory intervention. Expect discussions of recent claim issues and laws in the healthcare market as well as emerging issues in healthcare. The presentation will be beneficial to healthcare professionals working for health insurers, healthcare providers, auditors, regulators and healthcare providers and will also cover professionalism related topics for actuaries.

Description: The regulatory and market dynamics of the ACA's second decade are more predicable than the first. Come hear the latest information from industry experts on the emerging trends in ACA marketplaces. You'll also discover an understanding about emerging federal and state policy that will have pricing and financial implications. Finally, you'll get to learn what actuaries need to know to be well prepared for actuarial practice in the ACA's second decade. Key learning objectives include: - Comprehending the historical dynamics in the ACA's first decade which will shape the future - Understanding the changing national premium landscape for 2024, the 11th year of ACA marketplaces - Having a strong grasp on how the ACA's second decade will differ from the first from an actuarial perspective

Description: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.

Description: It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome.

Description: A diverse panel of health actuaries will be available to answer any attendee questions. An ACA question, we have it covered! A valuation question, we will find a solution. A professionalism issue, we will make a ruling! A regulatory concern, we will help guide the way!! No question is off limits! There are no stupid questions!