Description: WeChat is gradually becoming the main force of insurance online marketing for insurance products in China.

Description: The document is a research call for proposals seeking researchers to produce a report on the uses of synthetic medical claims data for actuaries. It outlines the background, purpose, research objectives, proposal requirements, selection process, and conditions for submission.

Description: High performance providers and in turn networks are often a prerequisite for a highly competitive product. If performance is lacking, the ability to offer a competitive product on the street can be significantly hampered. Learn from a case study how an actuary might measure performance and compare and/or rank network providers on multiple concrete factors. Discussed comparators will include efficiency, care management effectiveness, market attractiveness (enrollment changes), inclusion in other health plan networks, etc. By attending this session, you will be able to use principles discussed in this session to more effectively evaluate provider networks for their employer.

Description: Healthcare risk adjustment methodologies have become increasingly complex, largely due to the belief that complexity enhances accuracy. However, a disconnect exists between how healthcare risk is assessed and how payments are adjusted. This article explores the stark difference between measuring the accuracy of a risk assessment model at a member level, and that of a risk adjustment mechanism at the health plan level. I show that a highly simplified approach that does not use diagnosis codes can have similar accuracy on risk adjusted payments to models that do. These findings suggest that accuracy is not a barrier to developing simpler risk adjustment methodologies, which can improve payment accuracy and reduce the financial incentive for coding diagnoses.

Description: A priori, one would expect In Home Assessments (IHA) and Telehealth (TH) Encounters to identify some conditions that lead to actions that keep a member or two out of the Emergency Room. Similarly, one would expect Care Management and Disease Management engagement to ultimately influence some improvement in documentation that leads to more accurate Risk Adjustment. The business cases for these activities are often siloed to only the primary activity. The relationship between risk adjustment and care management is often more recognized as competing interests - one generally relying on utilization and the other trying to reduce it. Business cases can change dramatically when profiling has a more complete picture. This session will explore some techniques and share some observations - positive and negative - of the interactions between CoC and Risk Adjustment.

Description: Measuring the interplay between climate risk and morbidity and mortality is complex and often requires a multidisciplined team approach to meeting objectives. In this session, presenters discuss their journey and the twists and turns encountered in examining the link between wildfires, air quality, pollution, and morbidity and mortality implications. In addition to sharing their insights about the process, presenters will provide results from their, such as: - Mortality and morbidity risk trends influenced by climate change, wildfires, and air quality issues - Regional, risk class, socioeconomic, and temporal variations in these trends - Projections based on the observed trends and their implications for the future - The impacts on specific causes of morbidity and mortality, such as respiratory disease, cancer, and cardiovascular disease By attending this session, you will gain a better understanding of the following: - Implications of the study for life and health insurers - Key risk factors for individuals affected by air quality issues, the drivers for morbidity and mortality impact, and differences between the general and insured population - Process, data, models, and considerations needed for examining the mortality and morbidity consequences of climate risks like wildfires

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: Those with ADL and/or cognitive needs and their family caregivers are in great need of support across their acute medical and long-term care custodial requirements. Today many entities are supporting families with integrated care delivery and financing approaches.