2023 Health Meeting

Society of Actuaries

Come relive some of the best and most informative moments of the meeting. Play back these recorded sessions at your convenience and prepare to expand your knowledge and gain additional CPD credit for the new year with six expert-packed sessions, earning up to 7.20 CPD credits!

The Six Recordings include:

Value-Based Health Care Panel Discussion (60 minutes)

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.

Statistical Biases and Fallacies Common to Health Care Data (60 minutes)

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.

Emerging Pharmacy Trends and Their Impact on Health Care Costs Across Market Segments (60 minutes)

In this session, you will learn about key cost drivers in pharmacy trends, including but not limited to:

• New high-cost drugs, including gene therapies, that treat rare and/or expensive conditions such as spinal muscular atrophy (SMA), inherited retinal disease, hemophilia A and B, Duchenne muscular dystrophy (DMD), sickle cell anemia and cerebral adrenoleukodystrophy (CALD)
• Other cost drivers in the prescription drug category, including the emergence of GLP-1s, digital therapeutics, targeted immunomodulators, accelerated approval drugs and expanded indications
• The implications of the end of the COVID-19 Public Health Emergency (PHE) on the costs of COVID-19 vaccines, testing and treatment claims
• Downward influences on pharmacy costs, such as the availability of new generic drugs and biosimilars
• Emerging trends in pharmacy benefits manager (PBM) contracting, the initial portion of this discussion will be led by a pharmacist and former state pharmacy director.

You will also hear a panel discussion compare and contrast how commercial plans, Medicare plans and Medicaid programs are navigating the challenges that these trends present and how they are expected to impact costs in each market segment.

 
It's Not Just 'Affordability' - Post-ACA Insights on the Uninsured Population (60 minutes)

The Affordable Care Act (ACA) changed the health insurance value proposition for lower-income Americans. Consequently, the uninsured rate has dropped dramatically since the implementation of ACA marketplaces and the expansion of state Medicaid programs to a broader eligibility group. It is not difficult to connect the change in financial dynamics to the increase in health insurance coverage. At the same time, many Americans remain uninsured due to non-financial barriers. Identifying solutions to further reduce the uninsured rate is more difficult than intuitively 'spending more federal money'.

Explore the latest information on the nation's uninsured rate and provide fresh insights on how 'affordability' is not the primary concern.

Capitalizing on Uncertainty: Winning Strategies with the Inflation Reduction Act (60 minutes)

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.

 
Telehealth - Where It Is, Where It's Going (60 minutes)

Come explore an in-depth overview of telehealth to set context and navigate the continuing expansion of telehealth and its integration into the healthcare delivery system. You will examine the forces that shape telehealth offerings and expect a view of the possible futures of this evolving modality.

More Information, How to Register