Description: The COVID-19 pandemic helped accelerate many changes in the Health Care system that were already taking place. The major disruptions to the way providers operated was quite evident with shifting of focus away from elective services to create capacity for treating COVID-19. However, even before the pandemic, providers were adapting to changes in their environments.

Description: Actuarial Perspectives on COVID-19: June 10 Twitter Chat with the Society of Actuaries

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 1978 session focused on Group ASO and Minimum Premium Plans. Specific topics included: 1. Background - the need and motivation for adopting such plans, 2. Administrative Services Only Contracts, and 3. Stop-loss provisions.

Description: Health claims are not normally distributed. Claims Forecasting can be improved by understanding the entire distribution of plausible values of future claims, for example knowing there is an 80% chance future claims are between $340 and $375 PMPM. Confidence intervals around our estimates allow us to understand for each range around the best estimate (for example +/- 1%) what is the probability that future claims will fall in that range. Quantile Regression is a mathematical technique where you can estimate any percentile of the claims distribution you are looking for as a function of demographics, diagnosis indicators, prior cost variables, or other significant predictors. You can see which coefficients are important at different parts of the distribution. Individual and group distributions can be constructed. There are numerous applications in pricing and underwriting, stop loss, provider profiling, ACO target setting, allocation of group risk charges based on volatility, discounting strategy, and experience analysis.

Description: This article describes the functions of the National Center for Health Statistics which serves as the focal points for U.S. health statistics. The NCHS data collection program goes beyond the important vital statistics. The Center produces data on the extent of illness and disability in the population.

Description: This is the Introductory Study Note for the Society of Actuaries Group and Health-Company/Sponsor Perspective examination for Spring 2012 that will be given on Friday, April 27th, from 8:30 a.m. – 11:45 a.m. and 1:30 p.m. – 4:45 p.m.

Description: This is the Introductory Study Note for the Society of Actuaries Group and Health-Design and Pricing examination for Spring 2012 that will be given on Thursday, April 26th, from 8:30 a.m. – 11:45 a.m. and 1:30 p.m. – 4:45 p.m.

Description: Healthcare costs have been rising faster than general inflation for many years. Early models that predicted this past pattern projected healthcare expenditure growth that continued to outpace total expenditure growth leading to the fallacious position that the whole of the US economy would ultimately be consumed by healthcare. The Society of Actuaries' Pension Section and Health Section Research teams commissioned Professor Thomas E. Getzen of Temple University to construct a resource model for the projection of long term healthcare cost trends that includes capacity constraints to ensure the long-term projection is rational. The motivation for creation of the model was driven by its potential usage as a resource for the estimation of reportable liabilities for retiree healthcare benefits as specified under FAS 106 and GASB 45 accounting statements. This is a zip file containing the following: 1. A background paper on the creation of the health trend model, 2. The model, programmed in Microsoft Excel [xls format], that projects per-person expenditures and growth rates through 2099 using baseline assumptions, but also permits the flexibility for user–inputted alternative assumptions, and 3. Technical documentation providing transparency and support for the ultimate results.

Description: Managed care networks are important to control rising health care costs . these need to be priced appropriately to produce the right results for all stakeholders . This includes analysis of utilization and costs for both in and out of network claims . A variety of risk and administrative service options exist for entities assuming such risk .