Description: Regression to the mean (RTTM) is inflating your health care intervention evaluations if you are not carefully managing it's omnipresent and significant impact RTTM is the statistical phenomenon which arises when comparing sequential data points when an initial observation is extreme or an outlier, and states that with no other intervention, future observations will be closer to the average. Members who had high costs last year will, on average, have lower costs this year, even in the absence of any intervention or clinical program, simply by 'regressing' to the mean. This means that if your clinical programs are simply targeting members who had adverse medical experience last year, you’re targeting the wrong people. And if your savings methodologies are simply last year’s costs minus this year’s costs, the savings are inflated. By attending this session, you will be able to identify situations where RTTM will be a significant factor, how to eliminate it's impact when performing retrospective evaluations, how to identify prospects for clinical intervention with RTTM in mind, and more.

Description: Almost half of recent FDA approvals have been for orphan drugs. This trend is expected to continue in 2023. Orphan drugs are priced more than 30 times higher than non-orphan drugs, therefore their cost burden in aggregate has the potential to overwhelm the budgets of payers, especially that of smaller health plans. Hear how the cost impact analysis for smaller health plans require different considerations than for a larger health plan when modeling the impact of rare diseases.

Description: Recent research from Financial Finesse introduces a viable way to forecast the potential return on investment (ROI) of workplace financial wellness programs.

Description: Hear about some applications using quantile regression-derived individual and group claim distributions and how they may be used in various traditional health care modeling situations. The session will not focus on the technical use of quantile regression to obtain estimates of claim distributions, but more so is intended to focus on the uses of the distributions in actuarial modeling and the additive framework in assessing claims distributions. Presenters will show how actuaries can better assess risks by focusing on the individual- and group-specific claims distributions as opposed to traditional point-estimate-centric models.

Description: This paper surveys the actuarial techniques connected with salary scale mathematics for the valuation of defined benefit pension plans. Followed by several discussion papers submitted

Description: Health care has changed rapidly over the past couple of years. The pandemic has shifted consumer behavior in how and where they receive health care as well as consumer attitudes toward health care. Payers continue to design innovative solutions in responses to their patient’s needs and expectations. These changes in consumer behaviors and the responses by payers are expected to impact both health care cost and utilization. Discuss changes in health care that have emerged due to the pandemic and how they are expected to influence actuarial assumptions. Explore epidemiological models commonly used in the industry, the considerations when using these models, as well as the challenges with regards to gathering and interpreting relevant experience data. By attending this session, you will be able to: Identify shifts in consumer behavior that have emerged from the pandemic and describe how payers are responding to new patient expectations. Discuss how these post-pandemic changes by consumers and payers influence medical spending. Determine which actuarial assumptions are impacted and how and if the impact is expected to be temporary or permanent. Discuss considerations taken by actuaries and challenges faced when modelling actuarial assumptions post pandemic.

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: Recent research from Financial Finesse introduces a viable way to forecast the potential return on investment (ROI) of workplace financial wellness programs.

Description: Chapter 1 presents the background to the current study, followed by the methodology used, and a summary of the findings of the study. From Group Medical Insurance Large Claims Database Collection and Analysis, M-HB97-1.

Description: Open source programming languages have become a common part of the actuarial toolkit over the years. Using tools like R and Python, highly technical actuaries can automate onerous processes, easily work with massive amounts of data, create models and generate reports. Although these tools excel at turbo-charging analysts, it can be difficult for benefits to inure to the rest of the organization given the learning curve (“Can’t you just put this in Excel?”), control risks (“So your entire process could break overnight if some random person in Nebraska changes something?”), and internal IT environments. Listen in on a panel discussion where presenters share their personal stories of working with open source in a production setting. Hear about real world business problems, how open source tools were used, what risks were present, how they were overcome and the final business result.