2022 CCA Healthcare Meeting

April 12-14, 2022
Virtual Meeting

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Please note all times are shown in Central Time.

 

Sessions:

Session Handout

01 - Actuarial Leadership's Perspectives on Today's Hot Topics: A Payer Perspective Discussion April 12, 2022 10:00 AM - 11:15 AM

COVID 19 trends, cost transparency, health equity, the role of digital health, value-based care, social determinants of health. This session features actuarial leadership from a diverse group of payers discussing today’s hottest topics from their unique perspectives. Is there alignment between the areas payers are investing in, and the rapidly evolving needs of employers across cost, access, and the ability to address societal issues? Attendees will gain an understanding of where payers will meet employer expectations and be aware of any potential gaps where short- or long-term solutions may need to be put in place to meet an employer’s objectives.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

02 - Recent Developments in Provider Networks April 12, 2022 11:45 AM - 1:00 PM

The provider networks built by health plans are continuously being changed, narrowed or expanded to meet the needs of their customers. Representatives from health plans or consultants working with provider networks provide an update on recent network changes and future innovations in development.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

03 - Care-Management Programs and Centers of Excellence: Adapting to Societal Changes April 12, 2022 1:30 PM - 2:45 PM

The world has changed significantly over the last two years. How have care management programs and centers of excellence adapted to these societal changes? Our speakers discuss how the focus on member experience, health equity, value based contracting, digital health and other advancements are changing the dynamics in care management programs and Centers of Excellences’ improve health outcomes.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

04 - Professionalism for Healthcare Actuaries April 12, 2022 3:15 PM - 4:30 PM

This session features a courtroom format with judge, prosecutor, and defense attorney roles presenting “cases” of possible violations of professional/ethical standards by actuaries or their clients. Attendees act as the jury, deciding who is “guilty” or “not guilty” in each case using polling software. Each “case” outlines a real-world professionalism/ethical scenario that may not have a clear answer as to the right course of action relative to professional and ethical standards for health actuaries.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

05 - Actuarial Leadership's Perspectives on Today's Hot Topics: A Consultant Perspective Discussion April 14, 2022 10:00 AM - 11:15 AM

As a follow-up to Session 01, what are the various consulting firm's perspectives on the same COVID 19 trends, cost transparency, health equity, the role of digital health, value-based care, social determinants of health issues? This session features actuarial leadership from three major consulting firms discussing these topics from their unique perspectives. Are there commonalities among the firms' focus in serving their clients across cost, access, and the ability to address societal issues? Attendees can gain an understanding of where these major consulting firms will be focusing their energies to meet employer expectations and objectives in the coming years.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

06 - Preparation for 2023 Health Plan Renewals April 14, 2022 11:45 AM - 1:00 PM

The COVID-19 pandemic disrupted the healthcare system and patterns of patient usage of medical services and prescriptions drugs. Healthcare trends for 2020 actually declined for the first time in several decades and 2021 appears to have experienced unique disruptions to typical healthcare patterns. At the same time, we are seeing significant investments in innovative solutions with a focus on addressing the inefficiencies in our current healthcare system. As a result, planning for health plan renewals for 2023 has become a more complicated task for the healthcare actuary. Speakers provide you with insights into how best to plan for the 2023 renewal process.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

07 - Innovative Plan Designs and Carve Out Services April 14, 2022 1:30 PM - 2:45 PM

Panelists discuss the latest in carve out services and other evolving healthcare plan designs.

Session Category: Health & Welfare
Credits: CPD: 1.50
Session Handout

08 - Prescription Drugs April 14, 2022 3:15 PM - 4:30 PM

The speakers address questions on the prescription drug and medical pharmacy landscape. Topics include trends, specialty drugs and pharmacy, oral replacement of medical infusions (non-oncology and oncology), biosimilars, rebates and copay assist programs, and COVID-19 impact on prescription drug utilization.

Session Category: Health & Welfare
Credits: CPD: 1.50
  • 1 . James Dolstad Optum
  • 2 . Julie Jia Wang Clover Health
  • 3 . Daniel Rachfalski Aetna
  • 4 . Jeff B. Williams Blue Cross/Blue Shield of SC
  • 1 . David M. Tuomala Optum
  • 2 . Robyn King Optum
  • 3 . Melissa deGoede Vera Whole Health
  • 4 . Jeff Dobro Transcarent
  • 1 . James Dolstad Optum
  • 2 . Elizabeth Klunk Versant Health
  • 3 . Mylynn Tufte Optum
  • 4 . Katie McKee LifeSource
  • 1 . Chris L. Sipes Consulting & Risk Mgmt. Servs.
  • 2 . David M. Tuomala Optum
  • 3 . Edward M. Pudlowski MorningStar Actuarial Consulting, LLC
  • 4 . Justin N. Hornburg Justin Hornburg Consulting
  • 5 . Dale H. Yamamoto Red Quill Consulting
  • 6 . Cheryl A. Ham Aon
  • 1 . Dale H. Yamamoto Red Quill Consulting
  • 2 . Sunit Patel Mercer
  • 3 . Tim Stawicki WTW
  • 4 . Robert G. Tate Aon
  • 1 . Edward M. Pudlowski MorningStar Actuarial Consulting, LLC
  • 2 . Craig Bauer Aetna
  • 3 . Derek Tyson Ray Blue Cross/Blue Shield of TX
  • 1 . Adam J. Reese PRM Consulting Group
  • 2 . Brian McGuire Angle Health
  • 1 . Thomas Edward Persichetti Persichetti & Associates, LLC
  • 2 . Ian M. Smith Optum
  • 3 . Deborah Nagg OhioHealth