Description: Mental health and VBC have individually been buzzwords within the health community for many years, but rarely together. In this ‘ask the expert’ forum nothing is off limits, but these scintillating topics are a guarantee: unabated demand for mental health services post-pandemic, decreasing provider supply, rising provider burnout, access to care, management of chronic conditions, & medical/behavioral integration concepts including data fragmentation.

Description: The Centers for Medicare and Medicaid Services (CMS) implemented significant changes to the Medicare Star Ratings that are expected to result in cost savings to CMS. The 2024 Star Ratings were recently released in October 2023 which was the beginning of these changes where future changes will impact 2026 and 2027 Star Ratings.

Description: This session is intended to provide an update on past, current, and future studies done by the SOA GLTD Experience Committee. This includes an update on the ongoing Group LTD Incidence Survey including the nature of the study, goals, timelines, data submissions, and current status.

Description: As health insurance self-funding becomes more popular among smaller group sizes, risk is evolving for the MGUs, stop loss writers, and reinsurers that cover them. Assessing more small groups at lower attachment points means rethinking traditional stop loss underwriting techniques.

Description: Health Valuation and Stakeholder Views

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: The U.S. health care system continues to have its problems. It costs too much and even with public policy developments we are not meeting the desired objectives. What's next? What else can we do? Discuss some of the emerging ideas that are being pursued and the likelihood of their success at solving our collective problem.