Description: Health care continues to move from a fee-for-service model to a value-based care model. Hear from our expert panel how actuaries can play key roles in designing and contracting value-based agreements, monitoring experience, and driving results, as well as measuring value. The discussion will cover different structures currently in use, types of services covered (total cost of care, claim service lines, specialties, condition based, pharmacy products, etc.) and nuances by market (Medicare FFS, Medicare Advantage, Commercial, Medicaid). Listen to presenters discuss latest innovations in the value-based care space, as well as how current events have impacted these contracts. In this interactive session you will also be able to ask our diverse panelists questions.

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: This session will explore the evolving landscape of accident and health valuation, with a special focus on GAAP Long Duration Targeted Improvements. Discussion will delve into the intricacies of change brought by GAAP LDTI for calculation of both Lifetime Future Policy Benefits (LFPB) and Deferred Acquisition Costs, as well as potential downstream impacts to other activities related to general GAAP and STAT reserving such as experience analysis, model system conversion, financial planning and analysis, and statutory margin analysis. Attendees should be able to connect accounting and financial reporting concepts under GAAP LDTI to opportunities for technology modernization, improved transparency of financial analytics, and important considerations unique to Accident and Health products.

Description: The session is based on an article of the same name featured in the January, 2023 issue of Health Watch. It gives a step-by-step method of how to apply the average paid PMPM method to calculate IBNR with zero run-out, as opposed to current methods, which generally require a three-month run-out period. Methods for obtaining confidence intervals for the IBNR estimates will also be discussed.

Description: The Inflation Reduction Act represents the largest change to the Medicare Part D program since its inception in 2006. With a complete redesign of the Part D program coming in 2025 (the next bid cycle), there are health plan, operational and analytical challenges that lie ahead. In this session, you will: Hear highlights on some of the key changes occurring in 2025 Learn about key considerations for health plans and other stakeholders in the Medicare and commercial markets Discover potential winning strategies and potential analyses that could inform those strategies

Description: "Can you answer the question 'what are the chances we will lose more than $1 million next year?' without saying 'it depends'? If you miss a projection, can you quantify the chances that the miss was due to random variation vs. an incorrect projection? ten in as presenters demonstrate how to answer these questions and others using total risk analysis. Total risk analysis includes quantifying both the random variation risk and the projection risk associated with actuarial functions like pricing and reserving. After attending this session, you will be able to describe total risk analysis, apply total risk analysis to many actuarial functions."

Description: ReMark's Global Consumer Study delivers 10 key insights to empower customers. Insurers can design products that meet customers' needs and enhance client experiences and add significant value to their business. At the same time with new products being launched seemingly continuously, it is important to take a step back and assess risk throughout the product management cycle.

Description: In this presentation, actuaries and data scientists from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning. Presented with a unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their model development to the cloud and delivered a product in less than a week through a unique virtual engagement.

Description: This session is designed to inform you about the current state of mental health and mental health care in the United States, as well as future trajectories. By exploring topics such as plan design, provider network, provider reimbursement, and other relevant channels, this session aims to enlighten everyone on existing challenges and the strategies being employed to tackle them. Notably, this will include and highlight proposed changes to the mental health parity. Additionally, attendees will hear from a mental health provider/academic on these topics to gain a non-actuarial perspective.

Description: Join us in this webinar where we explore the intricate relationship between Professional Employer Organizations (PEOs) and insurance, diving into the art of risk management within this industry. Gain a comprehensive understanding of the diverse insurance products offered by PEOs, the positioning of PEOs in the actuarial landscape, and the strategic navigation of regulatory challenges.