Description: This is a book review of 'What Healthy People Know by Dr. Bob Gleeson, a book focusing on the seven things that healthy people do to say healthy and live long. The reviewer relates these activities to the actuarial career.

Description: "Spread pricing is a pricing methodology where pharmacy benefit managers (PBMs) bill a payer one price but reimburses the dispensing pharmacy a lower price for the same prescription drug. PBMs have historically relied on spread pricing as a revenue source. However, a growing number of states are introducing and passing legislation prohibiting spread pricing for Medicaid and commercial clients. In addition, new entrants to the PBM and mail-order pharmacy space are disrupting the market by offering services that promote increased transparency and member satisfaction. Expect updates on recent legislative trends and market disruptions targeted towards increasing PBM drug pricing transparency. By attending this session, you will have a better understanding of how changing legislation and market disruptions may impact current pricing methodologies."

Description: Investigate Deloitte's methodology to quantify the cost of health inequities attributable to racial bias, gender/sex bias and socioeconomic bias. We will illustrate the methodology by calculating total potential cost savings across different disease states and discuss both the role that actuaries play in addressing health inequity and the steps that organizations can take to activate health equity.

Description: Come explore an in-depth overview of telehealth to set context and navigate the continuing expansion of telehealth and its integration into the healthcare delivery system. You will examine the forces that shape telehealth offerings and expect a view of the possible futures of this evolving modality.

Description: Join this presentation covering the key provisions of the IRA which govern the selection of drugs for negotiation. We will also discuss what these changes mean for all Medicare Part D stakeholders, including: Government Beneficiary Part D Plans Drug Manufacturers Original Content:

Description: Attendees will learn what the Health Equity Index is, how it will be calculated, how it affects quality and Star metrics for Medicare Advantage plans, and how this could change the industry as a whole moving forward.

Description: The session will provide attendees with a framework of what goals to think about when building and utilizing a predictive modeling framework in New Sales and Renewal Underwriting mid-market, level funding, balance funding, and self-funding group health business.

Description: Listen to pre-eminent healthcare actuaries present their pitch for how they'd fix US healthcare (whatever the pitch thinks 'fix' means) if they were supreme policy maker for a day. No idea is too big, and no healthcare actuary's dream is too small.

Description: Among the many impacts of the Inflation Reduction Act’s redesign of Medicare Part D will be a change in Part D cash flows. Plan sponsors have always had to balance the seasonality of prescription drug costs against reimbursement at various times from monthly subsidies, risk score true-up payments, rebates, manufacturer contributions, and CMS settlements, but the IRA is changing the pattern of cash flows in 2024, 2025, and beyond. Moreover, the risk-adjusted portion of CMS revenue is likely to grow in 2025, even as the Part D risk score model changes.

Description: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.