Description: Keynote Speaker: J.D. Kleinke, Author and Medical Economist J.D. Kleinke has been instrumental in the creation of four health care information organizations; has served on the Boards of several health care companies; and spent many years advising both sides of the political aisle on non-partisan, practical approaches to health policy and legislation.

Description: The Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

Description: Article reviews the data a year into the unwinding of continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates have been adjusted, and compares those results to what has been modeled with the SOA Mediciad Unwinding model.

Description: Learn how insurers provide new opportunities for efficiency and value creation from product design and underwriting through customer engagement and claims. Glimpse some industry use cases for Gen AI and its outcomes as observed by the first movers.

Description: The Society of Actuaries Research Institute developed a new study to explore pharmacy financing. The goals of the SOA related to this research are to identify opportunities to increase transparency, encourage competition, align stakeholder incentives and mitigate increases in total cost of care. The research uses a value-based methodology.

Description: Discover the multitude of risk transfer solutions and payment models available to health claims payers for cell & gene therapies in this Society of Actuaries webinar. Delving deeper into the topic, we will examine the different types of solutions, weigh their pros and cons, and explore the future prospects of this rapidly evolving area of the healthcare landscape. By expanding upon the pricing and risk exposure discussion from session two, this webinar provides valuable insights into the dynamic market for cell & gene therapies and its implications for actuaries.

Description: Develop a better understanding of specialty drug trends and their increasing healthcare costs for more than the past decade by attending this webcast. With the introduction of price competition, you will see changes in the market for biosimilar products and patent-protected drugs. For example, the drug Humira will be gaining 10 biosimilar competitors in 2023. Alone, Humira can represent over 20% of total pharmacy spend for health plans. Join us and discover how price competition is a turning point for the pharmaceutical industry and will define its direction for the next decade.

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: The instructors in this boot camp session will highlight the SOA's work on an updated Medicaid underwriting margin model. This research project includes an excel model, a set of instructions and a paper describing the key components of underwriting margin, including cost of capital and risk margin.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.