Description: The Inflation Reduction Act represents the most significant changes to the Part D program since its inception 20 years ago. The implications will not only alter the benefits offered by Medicare Advantage (MAPD) and Prescription Drug Plans (PDP) but will alter the Part D cash flows and the seasonality of such amounts for interim reporting periods. In this session, we will provide a brief overview of the IRA changes and dive into how the changes could impact the 2008 Medicare Part D Accounting Practice Note.

Description: This article shows how COVID-19 affected retirement risks, and how retirement planning was impacted by COVID-19. It ties together COVID-19 and its economic consequences with results of two recent consumer surveys that examine retirement risk perceptions and financial well being and a more complete discussion of retirement risks. The Managing Post-Retirement Risks guide divided retirement risks into economic risks, risks and personal planning considerations, and unexpected and unpredictable events. Each of the risks discussed in the guide is discussed in the article with commentary on COVID-19 and its impact, and information about how to manage the risk. For each risk, there is information provided about any insights gained in the two surveys. Results of the two surveys linked to COVID-19 are also discussed.

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: 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: 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: 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: A look back at 2024, reviewing and highlighting the things that the SOA Health Section Council accomplished, including education, research, webcasts, networking, and a new Health Section Council action plan that will be used on an ongoing basis to target, track, and measure areas of focus for the council, to better serve membership.

Description: In this session, we will delve into the application of survey data analytics to extract valuable insights from public survey datasets. The discussion will start with the basics of survey design, sampling practices, and estimation of key statistics. Three case studies will be presented: one in the realm of population health and another in medical economics, both demonstrating the use of either SAS or R to perform the survey analytics.