Description: The SOA provides information about the actuarial career path in health care and predictive analytics. Throughout 2016, we will share more about actuaries who are tackling some of the industry's biggest challenges and hear from top employers in healthcare analytics.

Description: Carol McCall led three teams – predictive analytics, health economics and outcomes research, and personalized medicine. The “river running through them” was that they all leveraged data. Her predictive analytics team eventually built a broad portfolio of models with some of them having a significant impact on Humana’s top and bottom lines.

Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: Traditional risk scoring models include only fixed (non-random) demographic and condition-based variables. By including the provider effect as part of the risk scoring model as a random effect, we can get better estimates of provider performance (incorporating practice patterns conditional on patient morbidity profile). This approach can be generalized to study other factors that are now masked in error variance (i.e. area, Social Determinants) but if modeled could give us better estimates of risk

Description: In this presentation, actuaries and data scientists from Cleveland Clinic and Milliman discuss the development of a sepsis prediction model using machine learning. Presented with a unique challenge of handling massive amounts of data for near real-time risk scoring, the team took their model development to the cloud and delivered a product in less than a week through a unique virtual engagement.

Description: This video explains how cloud computing and APIs can help deploy AI solutions and their impact on the actuarial profession. It compares the old and new world of actuarial modelling using these technologies and discusses what actuaries should know about them. The video is presented by Arthur da Silva, FSA, MAAA the VP of Actuarial at Slope Software, a cloud-native actuarial platform.

Description: As health insurance self-funding becomes more popular among smaller group sizes, risk is evolving for the MGUs, stop loss writers, and reinsurers that cover them. Assessing more small groups at lower attachment points means rethinking traditional stop loss underwriting techniques.

Description: Learn more about the predictive modeling that was applied to industry data for the lapse and mortality experience in the post-level term period. Novel approaches were taken to model the shock lapse, subsequent lapse, and mortality experience. Observe a demonstration of the Tableau tool, which was built to allow users to analyze data on their own.

Description: Join us as we delve into the dynamic landscape of the Fixed Indexed Annuity industry. Presenters will discuss trends observed in recent FIA experience, observations from their own company's data, and findings from Milliman's FIA industry experience studies. Key results include a view of surrender behavior relative to market dynamics and comparisons with industry predictive models, serving as a benchmark to explore where industry experience aligns with expectations and where potential surprises have emerged. Through a combination of data-driven analysis and expert interpretation, attendees will gain valuable perspectives on the evolving FIA landscape, enabling them to make informed decisions to navigate future challenges.

Description: Following her first 100 days as the CMS Administrator, Chiquita Brooks-LaSure released her six strategic pillars for the agency. The Center for Medicaid and CHIP Services (CMCS) followed these pillars and laid out their priorities for states under the Biden-Harris administration. With these priorities established, recent 1115 submissions from several large states, including California, Massachusetts and New Jersey, may give insight to how CMS will operationalize their vision under this program authority. This session will include presentation from state policy staff who have led recent 1115 waiver proposals.