Description: This article focuses on the recent surge of digital medicine data being seen in the healthcare industry. While an increase in data can generally be perceived as good, it is important to remember that current privacy practices need to be maintained, if not strengthened, to continually protect healthcare members. The COVID-19 pandemic helped fuel digital medicine data, but it also created new avenues for privacy to potentially be compromised (i.e. healthcare employees using personal devices while working from home). Digital medicine data is a very powerful asset, but it is also a massive responsibility. If mishandled, this data can cause more harm than good.

Description: "Risk adjustment is an important aspect of establishing appropriate capitation rates. When a set of services is carved out for specific management under a sub-capitation, establishing appropriate adjustments for varying levels of underlying risk is more complicated. Dive into analytical and operational challenges and resolutions as presenters share more about developing a risk adjustment model specific to the carve-out of behavioral health services through a real-life case study. You will further explore a definition of the use case, availability of historical data sets, selection of the modeling approach, learnings from the iterative modeling process, and the potential application of the results. After attending this session, you will be able to: Understand why a behavioral health specific-risk adjustment model has business value Understand the unique challenges related to developing risk adjustment on member and cost subsegments Understand the impact of trade-offs between model complexity and interpretability in the context of implementation Increase awareness of data nuances and requirements unique to this type of project Describe analytic techniques that can be investigated for use in projects of similar business objectives"

Description: The SOA’s Individual Disability Experience Committee (IDEC) has reviewed industry experience for both claims incidence and terminations. Based on this review, the committee has published two reports with experience modifiers that when applied to the 2013 IDIVT table best fit experience from 2005 to 2015. During this session, the factors and their development will be reviewed as well as their impact on active and disabled life reserves.

Description: This will be the most fun you'll ever have learning about applying rigorous credibility standards in the real world! Measuring provider performance is crucial to value-based care, but no one wants to be told their data is not credible-so, what's an actuary to do? This session will mix in-depth theory with the messy realities of program implementation to give you tools for the real world. Whether or not you have ASOP 25 framed on your bedside table, you'll walk away from this session ready for the next time a business partner insists that 50 members 'is absolutely credible'.

Description: What is the value of the health care we pay for? As medical inflation continues to outpace general inflation, this question is more important than ever. As actuaries, we are often called upon to evaluate the value of medical care. Are the ways the value equation is commonly constructed reflective of our aspirations as a society? What gravitational forces do we need to be aware of that perpetuate the status quo, mental biases and methodological pitfalls and how do we actively work to correct for them?

Description: The dental and dental insurance industries continue to experience significant innovation advancements in a variety of areas including claims, customer acquisition, teletechnology applications, AI for dental disease progression and more. These advancements are occurring at the dental office as well as within dental insurance companies. Hear about some of the latest innovations in the dental and dental insurance spaces andl gain an understanding as to how cutting-edge developments will impact dental actuarial.

Description: Understand the role of food based interventions in health care. Learn the difference between produce prescription and medically tailored meals. Review new policies that will affect Medicare and Medicaid populations. Evaluate the possibility of health cost savings due to these interventions.

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.

Description: Critical illness insurance is a popular supplemental health insurance product in the U.S. market. This article discusses how carriers have recently sought to add value by expanded the benefits offered in their critical illness products. Specifically, the article discusses the consumer need and development considerations of adding benefits for autism Spectrum Disorder, Mental health disorders, Specified Disease Coverage, and enhance Cancer Coverage to a critical illness contract.