2017 CCA Healthcare Meeting

2017 CCA Healthcare Meeting

 

The CCA Healthcare Meeting provides health actuaries and other healthcare professionals the chance to hear the latest developments on the Affordable Care Act, and it affords the opportunity to discuss with peers what’s happening on the home front of healthcare reform. The meeting features a variety of sessions on healthcare issues, providing relevant education for healthcare providers, carriers and employers.

 

Sessions:

01 - Political Landscape: House of Cards April 05, 2017 1:00 PM - 2:30 PM

With a Republican majority in the House and Senate and a Republican administration, what’s to be expected? Election promises were to repeal the Affordable Care Act but many experts think it’s easier said than done. Our expert panelists provide an overview of their expectations and open up the discussion for the group. Expect a lively conversation on a topic that is sure to stretch out for a few more years and impact all of us personally and professionally.

Session Category
Health & Welfare
Credits
CPD1.80
Session Handout

02 - Personalized Medicine April 05, 2017 2:45 PM - 4:00 PM

Panelists address how advances in genomics redefine how patients are diagnosed and treated.

Session Category
Health & Welfare
Credits
CPD1.50
Session Handout

03 - Show Me…Your Data April 05, 2017 4:15 PM - 5:30 PM

Speakers teach actuaries practical ways to display data. Attendees learn how to format data for presentations in a meaningful, appropriate, and engaging manner to close the deal.

Session Category
Health & Welfare
Credits
CPD1.50
Session Handout

04 - Pharmaceutical Manufacturer Perspectives on Economic Value April 06, 2017 8:00 AM - 9:30 AM

Speakers at this session broaden the perspective of actuaries on the pharmaceutical delivery system for better pricing, reserving, and trend forecasting. The session is applicable to commercial individual, group commercial, Medicaid, and Medicare Part D insurance lines. Topics include a comparison of a life sciences company’s approach to economic value vs. actuarial approaches, exploring the emerging approaches of value-based contracting, and considering other issues affecting the pharmaceutical industry.

Session Category
Health & Welfare
Credits
CPD1.80

05 - Big Data and Healthcare - It's Not Just About Predictive Modeling April 06, 2017 9:45 AM - 11:00 AM

Speakers explore and discuss with the audience how data analytics could transform healthcare as we know it, and impediments that get in the way. How can we take advantage of available data to improve population health; reduce fraud and abuse; and identify and reinforce best practices?

Session Category
Health & Welfare
Credits
CPD1.50
Session Handout

06 - Rate Filings, Rate Review and Risk Adjustment in the New Regulatory Environment April 06, 2017 11:15 AM - 12:30 PM

The presenters focus on the impact of the new regulatory environment on rate filing and review process, and related actuarial issues affecting rate development and filing such as risk adjustment. Topics include actuarial assumptions, the Uniform Rate Review Template (URRT) and Actuarial Memorandum, and how they fit into the rate filing and review process for 2018 filings. Speakers include representatives from CMS/CCIIO for the Federal perspectives on the regulatory environment and rating, a consultant who prepares and submits rate filings. The speakers provide their perspectives on the challenges they see with the process and tools, and the new regulatory environment.

Session Category
Health & Welfare
Credits
CPD1.50
Session Handout

07 - MACRA - CMS Doubles Down on Quality Based Reimbursement April 06, 2017 1:15 PM - 2:45 PM

CMS has defined and consolidated most of the drivers of healthcare quality measurement and reimbursement through its regulatory mandates instantiated in the Medicare Access and Chip Reauthorization Act (MACRA). It will be the basis for alignment of provider value based reimbursement for the foreseeable future for healthcare programs that are regulated by CMS. While other options exist for the improvement in cost and quality, payers and providers will be primarily focused on aligning themselves to meet the MACRA requirements. The biggest change is to put the physician in the center of value-based care since the measurement of value will be based on quality and efficiency that the physician can impact. The long term implications are that MACRA will be used to create incentives for physicians to change the patterns of care for facilities and other sources of healthcare.

Session Category
Health & Welfare
Credits
CPD1.80
Session Handout

08 - A Study in Professionalism and Ethics for the Healthcare Actuary April 06, 2017 3:00 PM - 4:30 PM

What are ethics and how do we, as healthcare actuaries ,display them in our day-to-day professional conduct? Audience members react to real-world scenarios that challenge the question of what is professional ethical behavior for a healthcare actuary. Presenters at this session educate the audience with anecdotes and explore the various perspectives of a situation and the wide-range of possible actions and outcomes through discussion and debate.

Session Category
Health & Welfare
Credits
CPD1.80

  • 01 Edward M. Pudlowski MorningStar Actuarial Consulting, LLC
  • 02 Adam J. Reese PRM Consulting Group
  • 03 Mac McCarthy MorningStar Actuarial Consulting, LLC
  • 04 Dale H. Yamamoto Red Quill Consulting
  • 05 John R. Governale Actuarial Health Solutions LLC
  • 06 Andrew E. Kirchner Optum
  • 07 David M. Tuomala Optum
  • 08 Brian Charles Grossmiller
  • 09 Cara Jareb Willis Towers Watson
  • 10 Steven F. Cyboran Cyboran Consulting
  • 1 Brian Charles Grossmiller
  • 2 Jamison Feramisco Apri Health
  • 3 Phil Lerner Optum
  • 1 Gregory Pence LeanAnalytics.com, LLC
  • 2 Greg Fann Axene Health Partners, LLC
  • 3 William T. Eggbeer BDC Advisors
  • 1 Adam J. Reese PRM Consulting Group
  • 2 Franziska Moeckel Inova Center for Personalized Health
  • 1 Andrew E. Kirchner Optum
  • 2 Martin Marciniak Glaxosmithkline
  • 3 David Beshara Optum
  • 4 Whitney Pratt Optum
  • 1 Dale H. Yamamoto Red Quill Consulting
  • 2 Gary Claxton Kaiser Family Foundation
  • 3 Joseph Antos American Enterprise Institute
  • 2 Michael Cohen Centers for Medicare and Medicaid Svcs.
  • 3 Brent Plemons Centers for Medicare and Medicaid Svcs.
  • 4 Karen Bender Snowway Actuarial & Healthcare Consultants LLC
  • 1 David M. Tuomala Optum
  • 2 Roger Rosales The Standard