Ksenia Whittal, FSA, MAAA works at the Wakely Consulting Group, LLC. Ksenia developed a custom risk adjustment model for Arizona’s Medicaid program incorporating social determinants of health.

Timecodes below:

0 Intro

5 Who is an actuary?

7.20 Do you work in various health systems, how did the initiative in AZ start?

15.30 how did you define and measure SDOH?

19 used Z codes and CDC Social Vulnerability Index, anything else?

23 problems with disproportionate use of Z codes

27 How did you know that the model had significant predictions?

35 Process of redistribution between hospitals

27 In the paper your mention that risk adjustment transfers changed by -83% to 6%, what does it mean?

40 Have you tested whether there is value for patients and providers in including the information on SDOH?

46 Other states that pioneer SDOH and risk adjustment

50 Is there a way to systematically look at what states are doing regarding RA?

51 Other thoughts on SDOH. Why is there no gold standard yet?

54 Healthcare systems are set up with short-term health outcomes, and few incentives for long-term health investment. Outcomes data in SDOH stem from causes of death.

57 Changing health system for extended money returns. Members are leaving a health plan if improved. Stokeholds except the government have mixed incentives. 

Ways to connect: https://linktr.ee/Idrisovbu