Description: Similar to how states had made adjustments to their capitation rates to reflect acuity adjustments caused by the onset of the pandemic, states will need to modify the rates to reflect the unwinding since utilization patterns and average acuity per enrolled member will change. When the continuous coverage requirements set forth by the COVID-19 Public Health Emergency (PHE) ended, Medicaid-managed care programs across the country adopted various approaches to phasing out maintenance of effort (MOE) as a result of changes to the PHE-era continuous eligibility requirements. Phasing out the MOE requirement will ultimately result in members who no longer meet eligibility requirements losing their Medicaid coverage. Further, states are facing a wide variety of circumstances and are implementing diverse approaches to the MOE phase-out. This topic will be of significant interest to all actuaries and stakeholders of the capitation rate development process for Medicaid-managed care programs. Join us as we discuss the operationalization of the PHE unwind while referencing the SOA's research project which models the effects of the unwinding on Medicaid eligibility and population costs. You will learn about the various approaches that different states have adopted to manage the unwinding process, which will be instrumental for accurately pricing managed care rates.

Description: Research Objective The Society of Actuaries Research Institute General Insurance Research Committee is seeking researchers to identify and analyze the various by-component inflationary forces on pet insurance affordability in the United States and Canada. In addition, we seek ideation of potential solutions that are likely to improve the affordability of pet insurance.

Description: The purpose of this analysis is to provide a practical set of changes to the incidence rate modifiers of the 2013 Individual Disability Income Valuation Table to reflect recent industry individual disability income (IDI) claim experience trends from 2005 through 2015. The goal is to have resulting 2005-2015 experience-based incidence modifiers in a workable format to facilitate its use.

Description: In this video Mitchell Momanyi, FSA MAAA presents an informative breakdown of Medicare Advantage plans, delving into the intricacies of this alternative to traditional Medicare. Covering the inception of Medicare Advantage and its evolution, Momanyi explores the managed care companies offering Part C coverage, emphasizing the role of provider networks coordinated care. Concluding with key considerations for beneficiaries, Momanyi stresses the importance of weighing the pros and cons between Traditional Medicare and Medicare Advantage, while also emphasizing the evolving nature of the Medicare landscape and the regulatory nuances influencing enrollment decisions. Conributors: Mitchell Momanyi, FSA, MAAA, Deana Bell FSA, MAAA, Matt Emery, FSA, CERA, MAAA, Jon Forster, ASA, MAAA

Description: Cover a variety of topics centered around the unsupervised learning technique called 'clustering'. The presenters will take you through a wide array of topics that range from 'What is Clustering?' to 'How can I use this technique to solve problems I didn't even know existed?' In the health care industry, everyone is looking for an edge in reducing total spend-cluster analysis finds the unambiguous in an ambiguous framework of results.

Description: The Society of Actuaries (SOA) published its first COVID-19 research brief on March 10, 2020, followed by regular updates and expansions through June 12, 2020. The comprehensive report included a section of statistics that highlight the pandemic’s impact on economies in the U.S. and Canada. This report shows updates through September 30, 2020, to selected graphs from the Economic and Asset Impact section of the comprehensive report.

Description: This tool created graphs of Google's mobility Data. This version of the tool contains state-level U.S. data through July 31, 2020

Description: The Centers for Medicare and Medicaid Services (CMS) recently released the final 2020 Actuarial Value Calculator and Actuarial Value Calculator Methodology

Description: This SOA report describes the components of margin for calculating capitation rates in a Medicaid context along with practical issues that MCOs may face.

Description: The COVID-19 pandemic helped accelerate many changes in the Health Care system that were already taking place. The major disruptions to the way providers operated was quite evident with shifting of focus away from elective services to create capacity for treating COVID-19. However, even before the pandemic, providers were adapting to changes in their environments.