Description: The resumption of Medicaid redeterminations following the conclusion of the COVID-19 Public Health Emergency (PHE) represents a significant disruption across multiple lines of business in the health care market. While there has been much uncertainty regarding the timing and pace of the resumption of redeterminations, 2023 is beginning to bring clarity to the myriad questions posed by states, employers, managed care organizations (MCOs), and other interested stakeholders. Begin with a brief review of the latest developments regarding the end of the PHE and resumption of Medicaid redeterminations. Then, transition to a panel discussion on the various impacts that key stakeholders are starting to see, and expectations for short-term and long-term impacts to programs, plans, and businesses.

Description: Kevin Pierce, FSA MAAA divesinto the Inflation Reduction Act’s impact on US drug pricing. He discusses two key provisions: Inflation rebates, where pharmaceutical manufacturers must pay rebates to the government if drug prices rise faster than inflation, and drug price negotiation by Medicare, set to commence in 2026 for selected drugs. Contributors: Kevin Pierce, FSA, MAAA, Deana Bell, FSA, MAAA Mitchell Momanyi, FSA, MAAA, Jon Forster, ASA, MAAA

Description: Model design is an important part of being an actuary, and the SOA highlights the importance of the actuarial control cycle of model design, evaluation and monitoring. What tools are at our disposal for these steps? When should we be concerned or excited about model performance? Can we, and should we, use machine learning tools to assist with model improvement or development?

Description: In honor of Bob Barker's 100th birthday (December 12, 2023), we will examine the emerging development in the opaque world of health care prices. 'Referenced Based Pricing' has been a cost-cutting strategy applied by some self-insured employers, but administration, employee dissatisfaction with balance billing, and litigation have been barriers to growth. The new transparency data has yielded research indicating that 'cash prices' are lower than commercially negotiated rates in some areas. Dive in with industry experts as they discuss emerging trends of how consumers, employers, and health insurers will pay for health care services.

Description: The American Academy of Actuaries Health Solvency Subcommittee and the NAIC Health Risk-Based Capital (E) Working Group are in the process of analyzing and reviewing the H2-Underwriting Risk component and the managed care credit calculation in the health risk-based capital (HRBC) formula. Come learn what changes are ahead! While RBC is designed for solvency issues, also come hear about other ways health insurers manage their capital and surplus levels. Are others doing something you should try?

Description: This session will cover the current and potential use of artificial intelligence (AI) in the health care space. Participate in this interactive session and learn how AI is being used today and discuss its potential to reshape and revolutionize health care. You will get an opportunity to learn how AI can influence patient experience in every phase of healthcare delivery and talk about the challenges and limitations that arise with the use of this technology.

Description: This paper helps the audience understand the actuary’s role in estimating the financial impact of primary care programs. In addition, the paper can be used by actuaries to think about key issues when estimating the financial impact of their employers’ and clients’ own primary care programs.

Description: There are growing concerns that the Asian bird flu virus will evolve into a form that can be transmitted from human to human, thus unleashing a new global flu pandemic. This article uses the Spanish flu epidemic and the German life insurance portfolio to analyze the additional claims expenditure due to a pandemic.

Description: This report examines lapse experience on individual disability income insurance products by various policyholder and product factors. The study can be used for industry benchmarking as well as for background information for product development and planning purposes.

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 Key Statistics. This report provides updates to some of the data from the Key Statistics section of the brief and additional related data, organized by geography.