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

Description: In this session, we will provide examples and highlight real-world analytics that have been done to compare providers of tertiary and quaternary (T/Q) services (i.e., complex and potentially rare conditions). We also will address the need for analytics like this, who the potential audiences are, the data necessary to complete an analysis, and we will walk through actual case studies.

Description: The presenters will discuss current focuses in behavioral healthcare (MH/SUD). This may include cost and utilization trends, access to care, modalities of care (e.g., telehealth, app-based solutions, etc.), and other hot topics. The attendees will hear perspectives related to the overall landscape of behavioral healthcare in the US and how that impacts actuaries.

Description: With a decade of experience, mature Affordable Care Act (ACA) marketplaces continue to undergo significant changes amidst record enrollment levels. State activity has ramped up and similar themes have emerged. For example, an increasing number of states have either established or are considering operating their own exchange.

Description: Learn about the health care cost and utilization impacts of provider consolidation and shortages in the U.S. You will get an overview from a recent SOA research paper of the recent trends of, reasons for, and impacts of consolidation and shortages, as well an overview of the involvement of private equity's role in consolidation and shortages.

Description: Actuaries are leveraging predictive modeling and machine learning more and more as they strive to provide greater value to their stakeholders. Actuarial standards of practice provide guidance around modeling and data. The world has changed significantly over the last few years, so it is important these models be tested for fairness as well as any statistical biases. This article addresses some of the key issues actuaries need to be aware of as Corporations and society work through the responsible us of this technology and underlying data.

Description: Response to March 2021 Practice Note on ASOP 6

Description: This article focuses on mandatory supplemental benefits offered by general enrollment plans and Dual Eligible Special Needs Plans (D-SNPs) Medicare Advantage plans from 2017 to 2021.

Description: Actuaries are currently familiar with the impact of new technologies used primarily by clinicians and health care providers, such as new drugs and devices. The common theme emerging from many of the articles points to a technological revolution in health care accelerated by the COVID-19 crisis this year. Actuaries need to understand these technologies, their impact, learn how to drive this technological change and guide the response of their profession and their own health care organizations.

Description: This is the second article in a four–part series. In this article, the industry's products are examined.