The Medicare Advantage market is currently in the middle of a multi-year transition from the existing Risk Adjustment Processing System (RAPS) to the new Encounter Data System (EDS) for calculating risk scores. CMS has stated that ultimately EDS will be the sole diagnosis data source for Medicare Advantage organizations’ risk scores and revenue. Dave Dillon, FSA, MAAA, interviews Deana Bell, FSA, MAAA, on the topic and they discuss how the transition has shown to have a financial impact on Medicare Advantage revenue and how actuaries are well equipped to help.

Direct download: SOA17_22_Health_06_Medicare_Advantage_Risk_Scores.mp3
Category:Health -- posted at: 2:49pm CDT

During this podcast, Dave Dillon interviews Andrew Sykes about his non-traditional path to actuarial work and helping actuaries to develop the skills to influence other people to take specific actions based on their work.

Direct download: SOA17_28_Health_10_Influence_Training_for_Actuaries.mp3
Category:Health -- posted at: 10:45am CDT

Bayes’ Theory has been used to find a lost hydrogen bomb, break the German WWII code, identify smoking as a cause of lung cancer and heart disease, establish merit rating in insurance, and enable computers to “learn” and “make decisions.” But each time it was used, the techniques were not published, and the theory was allowed to die.  Actuaries played a prominent role throughout history in originally discovering Bayes’ Theory and resurrecting it to solve practical problems. Roy Goldman brings to life this actuarial history in his Contingencies article “Bayes’ Gift,” based on the book The Theory that would not Die by Sharon Bertsch McGrayne.

Direct download: SOA17_20_Health_05_Roy_Goldman.mp3
Category:Health -- posted at: 10:19am CDT

During this podcast, Joe Wurzburger interviews Dave Dillon about the Health Section Council’s initiative concerning healthcare reform. They discuss how the SOA is addressing education and research concerning the important issues in the ever changing health insurance landscape.

Direct download: SOA17_21_Health_Commercial_Healthcare_Whats_Next.mp3
Category:Health -- posted at: 11:26am CDT

The field of public health does important work around the world in keeping populations safe and healthy.  This podcast will explain how the SOA Health Section's strategic initiative on public health is working to educate and connect actuaries with the world of public health.

Direct download: SOA17_16_Health_04_Public_Health.mp3
Category:Health -- posted at: 8:10am CDT

During this podcast, Dave Dillon interviews Jackie Lee about an article she coauthored on telemedicine. They discuss how the current telemedicine landscape and why actuaries should be paying attention into these types of services as it has potential pricing impacts.  

Direct download: SOA17_13_Health_03_Telemedicine.mp3
Category:Health -- posted at: 8:15am CDT

Dave Dillon, FSA, MAAA interviews Randy Herman, FSA, MAAA about the November 2016 Health Watch article  “Review: Do Individuals Make Sensible Health Insurance Decisions? Evidence From a Menu With Dominated Options” that he co-authored. They discuss the sub-optimal health insurance choice decisions made by employees, methods to improve decision quality and how concepts from behavioral finance theory might help explain the results.

Direct download: SOA17_04_Health_01_-_Employee_Choice_Issue.mp3
Category:Health -- posted at: 4:26pm CDT

This podcast gives a brief overview of the payment systems being introduced by MACRA as well as the changes to Medicare Supplement.

Direct download: SOA17_05_Health_02_MACRA_Medicare_Supplement.mp3
Category:Health -- posted at: 10:36am CDT

Joe Slater FSA, MAAA talks about how under the Affordable Care Act (ACA), all groups with 50 or less employees will eventually be subject to the ACA’s modified community rating rules. While some groups will see lower premiums than they would have without the ACA, others will see significant premium increases. Though self-funding has historically only been a realistic option for groups with at least a few hundred employees, the premium disruption and potential loss of business caused by the ACA has incentivized insurance carriers and third party administrators to develop self-funded product offerings for small groups. These products are commonly referred to as Level Funding products.

Direct download: Health_Podcast_-_Level_Funding_with_Joe_Slater.mp3
Category:Health -- posted at: 5:11pm CDT

Dave Petta, FSA, MAAA and Karen Shelton, FSA, MAA discuss their article on Private Exchanges published in the May 2015 issue of HealthWatch  Listen as they describe the tenets of Private Exchanges, how they differ from Public exchanges and their current outlook.

Direct download: Health_Podcast_with_D_Dillon_K_Shelrton_and_D_Petta.mp3
Category:Health -- posted at: 9:43am CDT