Presidential elections are less than seven months away. What is the landscape of health reform given the potential changes in political winds over the coming months? We will explore this question in a panel interview of two prominent health economists who have provided policy advice to past Democrat and Republican presidential candidates.

Speakers

Does size matter? If you are referring to mandates, penalties, tax credits, metal levels, marketplaces, and Minimum Essential Coverage, the answer is yes.

During this session, attendees learn which portions of the Affordable Care Act (ACA) impact which size employers and how employers of different sizes are reacting to these regulations in terms of how, why, where, when, and if they purchase healthcare coverage.

Speakers

The presenters focus on the practical aspects of the rate filing and review process. 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 2017 filings. Speakers include a representative from CMS CCIIO for the Federal perspective, a state regulator who reviews rate filings, and a consultant who prepares and submits rate filings. The speakers provide their perspectives on the challenges they see with the process and tools, and what common issues or errors they see in reviewing or submitting rate filings.

Speakers

Accountable Care Organizations (ACOs), led by providers, were supposed to be a new approach to realize value based on better cost effective outcomes. Some ACOs were going to put the primary care physician in charge while others seem to focus on the specialist as the key driver of value. Our panel discusses their experiences with ACOs and current trends.

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How does the ACA measure up against the Institute for Health Improvement’s Triple Aim of Reducing per capita cost, improving the patient experience, and improving population health?

Panelists at this session debate the pros and cons from the perspectives of various key constituencies.

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The regulations around the administration of the high cost plan excise tax (i.e., “Cadillac Plan” tax) are being contemplated by the IRS and debated by actuaries and employers across the United States. With less than two years before the tax goes into effect, employers are focusing on its potential effects on plan costs as well as the means to administer the potential regulations. Speakers at this session focus on the guidance provided to date on the administration of the excise tax and the implications for employers including:

• Potential approaches for determining the cost of applicable coverage subject to the tax;
• Aggregation by benefit package and mandatory disaggregation by family tier;
• Calculating costs for FSAs, HSAs, HRAs, on-site medical clinics, EAPs, etc.;
• Timing of the determination of the cost and the availability of data;
• Application of the annual statutory limit to the cost of applicable coverage; and
• Age and gender adjustments to the annual statutory dollar limit.

All of these issues and more are to be discussed by an expected expert panel consisting of healthcare actuaries and a representative of the Internal Revenue Service.

Speakers

We now have the actual results for the first year of the risk mitigation programs under ACA and are starting to establish estimates for 2015 expected results. We are also entering the final year for the two temporary programs that end after 2016. Speakers at this session cover the historical experience under the programs, future changes and adjustments under consideration from a regulatory perspective, and issues and challenges faced by carriers required to report their results including the impact of the phase-out of the two temporary programs at the end of 2016.

Speakers

We have enjoyed a relatively stable healthcare trend environment in the last few years (averaging 4 percent compared to 15 percent trends a decade earlier). Can this level of relatively low trends sustain itself? What are potential cost drivers that will change the pattern of healthcare cost trends? How will the proliferation of specialty drugs influence future health care costs? The panel addresses these issues as well as others.

Speakers