Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: It's your first full day of productive learning! Start it off right with a delicious breakfast and warm welcome.

Description: Pharmacy prices are top of mind for many consumers, policymakers, and payers. While there have been many efforts to reduce pharmacy costs over the years, many believe these efforts only helped us cope with the symptoms of the problem without providing a comprehensive cure for the underlying causes of this problem. The Society of Actuaries Health Section sponsored this Pharmacy Partnership Forum to gather multi-disciplinary experts in the pharmacy ecosystem. This report shares the insights and learnings that emerged from this group of health economics outcomes researchers, clinical pharmacists, medical doctors, health actuaries, benefits consultants and brokers, and their collective thoughts on advancing this exploration for society’s benefit.

Description: Connect with the health actuarial community -- explore innovative solutions, advance your career, and participate in engaging, interactive events. Join the industry’s leading actuaries, analysts and professionals to network and discuss the impacts of the latest marketplace factors and trends.

Description: Learn how medical coding, claims, data-sourcing and more are relevant to actuarial work in the health care field when you sign up for this SOA e-course.

Description: Get up to date on the current and potential use of artificial intelligence (AI) in the health care space. In this interactive session, you will learn how AI is being used today and discover its potential to reshape and revolutionize health care. Take advantage of the opportunity to find out how AI can influence patient experience in every phase of health care delivery, and join the conversation about the challenges and limitations that arise with the use of this technology.

Description: Connect with the health actuarial community -- explore innovative solutions, advance your career, and participate in engaging, interactive events. Join the industry’s leading actuaries, analysts and professionals to network and discuss the impacts of the latest marketplace factors and trends.

Description: What are Biosimilar drugs? Are they the same as generic drugs? What potential impact might Biosimilars have in the United States prescription drug landscape and it’s economics? This article explores those questions as well as exclusivity and interchangeability.

Description: When designing and pricing a healthcare product, it is not only important to know how to model frequency and severity, but it is essential to understand human behavior. Of course, the issue of anti-selection in medical insurance is well known as individuals know more about their health and prior expenditures than an insurer does. This type of behavior is certainly rational, and to be expected.

Description: Inspired by other financial savings products available to Canadians, this article describes a potential solution for financing future health expenses with the creation of a Registered Health Savings Account (RHSA). This solution has been thought on the basis of four premises : 1- Individual Accountability for Health Expenses; 2- Early Savings Leads to More Accumulation; 3-PreferredTax Treatment for Personal Health Savings; 4- Complementing current public and private health systems; Main elements of the RHSA are described (Contributions, Accumulation, Utilization of account, Management by financial institutions).RHSA'S expected balances and some other results under three scenarios (a person in good health, one in poor health, and one with unexpected death at age 45) are summarized in a table. Health expenses deducted yearly from RHSA's balance were estimated using total, per capita, provincial government health expenditures by age-band for Canada, in 2020, from the Canadian Institute of Heath Information’s (CIHI), which account for 71.8% of total expenditures, that is public + private. Thus 28.2% of total expenditures were used for private health expenditures, then forecasted to 2024 and projected using a 4% annual trend. Some objections to the solution explored were anticipated as well as some refutations to these objections.