SOA Webinars

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Overview

Summary of research from the Initiative 18/11 

• Pharmacy team about the drug development process for traditional pharmaceuticals: Who does the research and discovery?
• What does the research and discovery process entail?
• How are targets identified and validated for research and discovery?
• What are clinical trials and how are they conducted? 
• How is the drug development process regulated? 
• How is the drug development process funded? 

At the conclusion of this session, attendees will be able to answer:

• Who does the research and discovery for new pharmaceuticals? 
• What does the research and discovery process entail? 
• How are targets identified and validated for research and discovery? 
• What are clinical trials and how are they conducted? 
• How is the drug development process regulated? 
• How is the drug development process funded?

Agenda and Speakers

Moderator(s): Gregory Warren, FSA, MAAA, FCA

Presenter(s): Kerri Miller, PharmD; Ian Smith, FSA, MAAA

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Overview

Openness to and acceptance of diverse perspectives, cultures and backgrounds helps to attract the best talent and ensures the overall inclusivity of the actuarial profession. The panelists will discuss how including a group of diverse actuaries and other employees help make a difference in the work environment. 

At the conclusion of this session, attendees will be able to: 

• Recruit and develop a diverse workforce 
• Consider appropriate accommodations for employees to succeed.

Agenda and Speakers

Moderator(s): Sara Teppema, FSA, MAAA, FCA

Presenter(s): Craig Kalman, FSA, MAAA; Rolande Mbatchou, ASA, MAAA; Margaret Resce Milkint; Sara Teppema, FSA, MAAA, FCA; Mary Vollkommer, FSA,MAAA

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Overview

The always popular Medicaid Hot Topics session is back with discussions from an expert panel on the most riveting Medicaid topics of the year. These could include the following: 

• Medicaid Fiscal Accountability Proposed Regulations 
• Tennessee's Block Grant Proposal 
• ACA court battles: What are the potential impacts on Medicaid? 
• Pass-through payments are converting to directed payments: What is changing? 

Medicaid is dynamic and it is difficult to stay current on all of the changes. This session provides insightful discussion into the major changes that impact actuaries and their companies or state clients. 

At the conclusion of this session, attendees will be able to: 

• Educate their employers and clients on the changes in Medicaid and how they impact them 
• Evaluate the impacts of the changes on their employers and clients 
• Create strategies for dealing with the changes that are taking place in Medicaid

Agenda and Speakers

Moderator(s): Sabrina Gibson, FSA, MAAA

Presenter(s): Taylor Pruisner FSA, MAAA; Daniel Schnur, FSA, MAAA; Jaredd Simons, ASA, MAAA; David Wierz

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Overview

Telehealth enables the delivery of health care services to patients that are not in the same physical location as the service provider. Over the past decade, telehealth has been used increasingly to complement face-to-face patient encounters, and is particularly important to addressing health care needs in rural areas. The COVID-19 pandemic has served as an extraordinary catalyst for telehealth adoption through the early part of 2020. As folks of all ages and morbidity profiles have been forced to shelter in place and maintain social distance, telehealth providers have quickly ramped up capacity to accommodate a remarkable surge in volume. Other regulatory catalysts, particularly in the Medicare Advantage program, have further served to elevate the visibility and importance of telehealth in the overall health care delivery system. Starting in 2020, Medicare Advantage plans can offer any clinically appropriate physician services through telehealth as part of the standard Medicare benefit. Network adequacy standards can also be met via telehealth providers within certain programs. This presentation will cover the basics of what constitutes telehealth, provide illustrations of current telehealth technology. We will cover the what, the why, and the where (anywhere) of telehealth in 2020 and beyond.

Agenda and Speakers

Moderator(s): Tim Murray, FSA, MAAA

Presenter(s): Terry Beck, VP, Teledoc Health; Tim Murray, FSA, MAAA; Jean Glossa, MD, MBA, FACP

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Overview

Join us for the Health Section Breakfast (for Lunch) where you will hear an update on the activities of the Health Section Council. Then, Mark Ishaug will discuss social determinants of health and its impact to actuaries and our work.

Agenda and Speakers

Moderator(s): Jackie Lee, FSA, MAAA

Presenter(s): Mark Ishaug

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Overview

Many new and innovative companies are leveraging technology to improve the effectiveness of the care provided to patients. They are employing better tools to identify patients who can benefit from specific programs that best meet the patient's needs. They are also dramatically increasing the use of these programs by guiding plan members through the maze of offerings to match them with the programs that will be most beneficial to them. Employers are making these third party programs available to their members, and Medicare plans are using these new tools to identify emerging health risks for early intervention and more accurate risk scoring. This session will explore some examples of these programs, how they are being effectively integrated into the operations of health plans and how the results of these programs are being measured. 

 At the conclusion of this session, attendees will be able to: 

• Better evaluate point solutions offered by health plans
• Identify ways to increase the use of third party solutions
• Identify Medicare Advantage members where risk scores may not be capturing early onset dementia
• Compare primary care approaches to those demonstrated to lower health plan costs

Agenda and Speakers

Moderator(s): Edward Cymerys, FSA

Presenter(s): Raj Behal, M.D. MPH; Mylea Charvat, Ph.D.; David Sotelo, FSA, MAAA

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Overview

This session will explore the various contracting techniques that CMS, providers and employers are using to achieve their strategic objectives across both the commercial and Medicare markets. For commercial, we will discuss bundled payments, direct primary care and other contracting models for provider risk. For Medicare, we will focus on CMS's Direct Contracting model and how it fits into the suite of provider options for taking risk. 

At the conclusion of this session, attendees will be able to:- 

• Differentiate between the provider risk options available in the Medicare and commercial spaces 
• Define contracting models such as bundled payments, direct primary care, on-site health clinics, shared savings arrangements, reference-based pricing and network replacement
• Understand CMS’s new Direct Contracting Model and evaluate how it compares to other Medicare models
• Identify strengths and weaknesses, and evaluate the potential financial outcomes of each contracting option
• Consider which risk sharing strategy is best for the needs of an individual organization

Agenda and Speakers

Moderator(s): Brian Sweatman, FSA, MAAA

Presenter(s): James Lucas, ASA, MAAA; Matthew Smith, FSA, MAAA; Brian Sweatman, FSA, MAAA

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Overview

Court is in session and you are the jury! Follow along as challenging aspects of actuarial professionalism are explored in a court-like setting. Deliberate based on what you already know from your own experience, as well as what you learn in this session. Then, deliver your verdict accordingly. Who says learning about actuarial professionalism can't also be fun? 

At the conclusion of this session, attendees will be able to: 

• Apply actuarial professionalism concepts
• Identify key ASOPs for health actuaries 
• Explain significant aspects of the U.S. Qualification Standards

Agenda and Speakers

Moderator(s): Joe Wurzburger, FSA, MAAA

Presenter(s): Deana K. Bell, FSA, MAAA; Jacqueline Lee, FSA, MAAA; Tenesia R. McGruder, FSA, MAAA; Joe Wurzburger, FSA, MAAA