Description: Python has become the fastest-growing major programming language in the world. It has surged in popularity over the last decade, following the development of its industry-leading capabilities in data science, machine learning and artificial intelligence, and it is now one of the most globally popular and widely used languages. In this article, I discuss some of the reasons for its popularity and explain why many actuaries and insurers have started using Python.

Description: This article begins with a comparison of the commercial risk adjuster to the exisiting Medicare model, and goes on to discuss why the existing strategies employed by health plans will not work in a risk adjusted environment. The article elaborates on the importance of diagnosis coding, controlling member mix, and care management in order to mitigate risks and gain from newly created opportunities.

Description: Read the October 2020 issue of Health Watch published by the Health Section. Newsletters provided practical information for the working actuary, articles on trends that impact sections and news about section activities.

Description: Introduction to additional actuarial research into development of and regulatory impact, economic impact and consumer impact of prescription drugs in the United States. Intended to further educate actuaries and others who work in this area and motivate more actuarial involvement to increase transparency, increase competition, better align stakeholder incentives and better mitigate total cost of care increases

Description: A high level summary of the basics of Medicare Part D settlements - what they are, and the impact they have on plan sponsors' final financial results. Intended for an audience with limited familiarity with Medicare Part D.

Description: Regression to the mean is a phenomenon that arises when comparing sequential data points. It states that when an initial observation is extreme or an outlier, future observations will be closer to the average. Health care actuaries need to understand and be able to mitigate the effects of regression to the mean to avoid misapplying predictive models or misstating measurements of historical effects.

Description: MACRA not only impact providers, it will impact the entire healthcare market. MACRA published studies and commentary to date have primarily focused on providers, with the majority of the information addressing the impacts to clinicians. However, our investigation indicates MACRA has far reaching impacts to payers as well as providers. MACRA is impacting each geographic market and line of business in a unique way, and health payers will have multiple strategic decisions to consider given the changing market dynamics.

Description: This article explores the disruptive applications of blockchain, an emerging technology, and its impact on the pharmacy benefit space, and pharmacy benefit managers (PBM).

Description: This article focuses on mandatory supplemental benefits offered by general enrollment plans and Dual Eligible Special Needs Plans (D-SNPs) Medicare Advantage plans from 2017 to 2021.

Description: Actuaries with Medicare expertise regularly receive information specific to either Part C or Part D, but a key component of successful bid preparation is effective coordination between these two programs. This article explores pricing and regulatory common ground between Part C and Part D bids to aid actuaries as they guide decisions impacting both benefits.