Description: By rationing health care resources, managed care organizations have raised ethical and legal issues not commonly found under previous financing structures. This session 95PD of the Palm Desert Spring Meeting addresses these issues. From the Record of the Society of Actuaries, Vol. 23, No. 1.

Description: Health insurance company assets and liabilities have evolved since the Patient Protection and Affordable Care Act (ACA) was signed into law in March 2010. The ACA fundamentally rearranged how commercial health insurance is funded by integrating federal premium subsidies and pass-throughs together with a marketplace interwoven with transfer payments among stakeholders. The impacts of these programs can be seen in specific accounting items on the balance sheets of health insurance companies over the past 10 years. Their emergence follows three primary trends: (1) balance sheet items tend to be larger and take longer to settle, (2) there are more interactions among items, and (3) the final settlement amounts are more uncertain.

Description: This session discussed: Relative roles and interdependencies between providers and insurers - traditional and future Risks and financial incentives from the provider perspective Marketplace forces determining trends in inflation and utilization in the health care arena. From Record of the Society of Actuaries Vol. 11, No. 1 in San Francisco

Description: "Direct medical costs for cancer care topped $209 billion nationally in 2020, accounting for a significant proportion of all health care expenditures in the U.S. Indirect costs are also significant, encompassing loss of productivity, wages, leisure time and decreased quality of life. The way cancer programs deliver and are reimbursed for care is rapidly changing. As the cost of cancer care continues to rise, several new value-based care programs - both public and private - have attempted to curb these rising costs. Learn about the current landscape of VBC oncology programs, several key challenges and opportunities with oncology analytics, as well as anticipated evolution of cancer care in the near future. Topics include: Current VBC oncology landscape, including a more detailed discussion on CMS' latest oncology program, Enhancing Oncology Model (EOM) Discussion on current challenges and opportunities with oncology analytics, including some advanced methodologies that have been developed based on documented clinical pathways to better understand cost drivers Future state of oncology care including emerging pharmaceuticals and novel therapies, personalized care regimens, and other clinical innovations"

Description: The report looks at the different outcomes for the 50 states from the ACA, in terms of cost and availability of health insurance coverage. It identifies 11 key observations since the passage of the ACA.

Description: This session features a moderated discussion between medical professionals who are experts in long-term care. The presenters are outside the LTC insurance industry altogether, which will ensure that attendees receive a truly external perspective.

Description: Our three panelists represent a cross section of the health-care industry. The topics they will each discuss will include a range of broad to specific types of health-care innovation, and they will describe the process of showing value related to the innovation discussed. From Record of Society of Actuaries, Vol. 22, No. 2.

Description: A study of whether tobacco, area and industry rating in one state may be reflecting unintended factors such as race, ethnicity or socioeconomic status. This study does not consider whether the rating factors accurately reflect underlying claims costs.

Description: Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the impact big data and predictive modeling is having on the health care industry

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.