Description: Actuaries team up with Payers and Providers, to share insight into their data-driven approaches for improving health plans' CMS Medicare Star Ratings, which leverage experiential analytics to create solutions. 'Experience' is the king-it is broader umbrella, which includes and addresses engagement, cultural competency, equity, cost, and lastly, 'quality'. By attending this session, you will be better equipped to turn real-life data into actionable business solutions-essentially, data science in action. Further, you will better appreciate the importance of stars and risk adjustment in the Medicare Advantage space, along with the consequences of coming up short.

Description: These discussions at the 1967 New York and New Orleans Regional Meetings covered topics related to individual life and health insurance including health topics, individual life underwriting, reinsurance, individual policy pension fund expenses, tax sheltered annuities, and market testing products.

Description: The Actuary Vol. 22, No. 6. The author provides commentary regarding an interview with Paul Barnhart reported on in The Actuary March 1988 concerning the controversy over health insurance reserves. Specifically the elements of the “Benefit Ratio Reserve” method were analyzed.

Description: This report examines lapse experience on individual disability income insurance products by various policyholder and product factors. The study can be used for industry benchmarking as well as for background information for product development and planning purposes.

Description: How do we take a Minimum Viable Products (MVP) approach to launch new insurance products? Join this moderated discussion and focus on three key development aspects: Distribution, Systems, and the design and pricing of the Insurance product itself. Come discuss reasons to choose an MVP approach and how it solves many of the product launch challenges.

Description: This general discussion looks at mortality experience with the advent of CSO tables, annuity premium tax, termination dividends, classes of agents included under Social Security, and conditions affecting companies entering the fields of disability income, accident, health, hospitalization and medical insurance.

Description: Discussion of the standards set by ASOP 23 on data quality within a health insurance context.

Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.

Description: This paper describes a computer package for analyzing AIDS data named AIDS-PAC that: 1. adjusts AIDS case counts to account for reporting delay, 2. estimates the size of the HIV infected population, 3. provides short-term forecasts of the extent of the AIDS epidemic. Actuarial Research Clearing House 1991 VOL. 1

Description: Report to give actuaries practical information and guidance on LTD claim credibility for case level pricing and underwriting. Stage 2 of the GLTD Credibility Study, this analysis was expanded using the industry data gathered during Stage 1.