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May 16, 2022

Solutions in healthcare to drive better care at a reduced cost have grown significantly over the past 5 years.  Dave Dillon talks to Ed Pudlowski about the role health actuaries play to bring credibility to the claims made by these solution providers.

May 2, 2022

For pricing actuaries working in the individual exchange market, the metallic plans created by the ACA – bronze, silver, gold, and platinum – have been anything but simple. Do new state mandates around actuarial sloping assumptions create better deals for customers, or do they make an already confusing problem even...

Apr 18, 2022

In this episode, Dave Dillon interviews Dustin Ryan, FSA, MAAA about the everchanging landscape of Medicaid pharmacy.  They discuss how the states pulling the levers in the pharmacy world to lower their drug expenditures.  They dive into the impact of state impacts on MCOs and the future of pharmacy.

Apr 4, 2022

Dave Dillon interviews Jeff Wu who is the deputy director for policy of the Center for Consumer Information and Insurance Oversight (CCIIO). Dave and Jeff discuss a wide-range of Affordable Care Act topics including Open and Special Enrollment periods, risk adjustment, induced demand factors, CSRs, and 1332 waivers.

Mar 21, 2022

Join Jackie Lee as she sits down with Mike Pacolay to discuss his article on the utilization of member advocates as a cost savings tool for employers to help lower claims costs for its employees.  With confusion at nearly every turn, consumers become some combination of scared, confused, angry and frustrated, but with...