Description: Inflation and the possibility of recession are major factors affecting health care cost increases over the next five years. Insurance and medical organization will continue to evolve but are unlikely to create major shifts in the short run. However, over the long run structural changes in providers and payment mechanisms will determine future trends – raising or lowering the health share of GDP depending upon public choices and private decisions.

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: The impact of COVID-19 on life insurance is a matter of frequent discussion, but the impact on disability insurance has been less understood. This session uses survey data and other information to explore how COVID-19 has affected short-term disability, long-term disability and Social Security Disability Insurance.

Description: Discover results of the ongoing SOA COVID-19 Group Life Mortality Survey. It will also compare Group Life mortality results to U.S. general population excess mortality trends, and explore some of the non-COVID drivers of excess mortality.

Description: This presentation will explore innovative approaches to high performance networks (HPN). The session will compare the more traditional narrow network solutions offered by national carriers vs. different models established by newer vendors that focus on a different value proposition and/or does not involve narrowing the network at all.

Description: The Medicare Advantage (MA) program is facing challenges in the coming years due to a number of headwinds: Star rating program changes, the Inflation Reduction Act (IRA), revenue pressures, mergers/acquisitions, and risk score model changes, just to name a few.

Description: Fifty-three percent of Americans responding to a survey conducted by the Society of Actuaries (SOA) Research Institute reported that extreme weather events – including hurricanes, tornadoes, heatwaves, wildfires and flooding – have adversely affected their health.

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.