105 - Intersection of Price Transparency and Network Evaluation

For health actuaries, the traditional reliance on network discount metrics is being challenged by a new wave of cost transparency regulations and machine-readable files (MRFs). Speakers explore how the public release of negotiated rate data changes the way actuaries evaluate provider networks, assess plan competitiveness, and support pricing strategies. Presenters discuss practical ways actuaries can incorporate MRF data into their work—highlighting use cases in benchmarking and analysis across employers and providers. The speakers also address the limitations and complexities of this emerging data source, and how actuaries can balance transparency-driven insights with actuarial rigor. Designed for health actuaries working in pricing, network analytics, or provider strategy, this session offers actionable perspectives on navigating a rapidly evolving reimbursement landscape.

Speakers:

Aaron Paul Jurgaitis

Optum

Edward Hausman

Deerhold Ltd.

Jessica Arnold

Alight Solutions

Meghan Rausch

Aon

Robert G. Tate

Aon

Credits:

CPD Credit: 1.50 EA Core Credit: EA Ethics Credit: EA Non-Core Credit: EA Formal Credit: