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: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: 2021 ImpACT Conference - Session 2D Value-Based Models for Home-Based Care and Digital Health 10.25.21 Recording

Description: 2021 ImpACT Conference - Session 6C: Reshaping the Roles of Actuaries - A Case Study 10.27.21 Recording

Description: 2021 ImpACT Conference - Session 5A: Pandemic Rewind: Risk Management and Scenario Modeling Learnings 10.26.21 Recording

Description: 2021 ImpACT Conference - Session 4D: Risk Neutral ESGs for LDTI Market Risk Benefits 10.26.21 Recording

Description: 2021 ImpACT Conference - Session 14D: Completing the Cycle: Decumulation Innovations 10.29.21 Recording

Description: 2021 ImpACT Conference - Session 6B: A Courtroom Case: Data Democratization to Drive Analytics? 10.27.21 Recording

Description: 2021 ImpACT Conference - Session 4C: Technological Barbarians at the Gate: Learning from Upheaval in Other Industries 10.26.21 Recording

Description: 2021 ImpACT Conference - Session 5D: Data Science: The New Frontier for Evaluating Digital UW Evidence 10.26.21 Recording