Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: In this interview Dr. Reinhardt shares his thoughts on the role he believes actuaries should take in the health care system reforms.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: The article explores the possibility of using the emerging technology for life insurers to build a monitor system for better risk and profitability management.

Description: This session is about meeting the needs for financial information in managing an insurance company. Topics include: 1. What are management's basic needs how are they met can financial systems continue to meet the challenge? 2. Are fundamental changes ahead for GAAP reporting? 3. Is it time for mutual companies to provide more meaningful financial information? 4. Can current regulatory reporting meet the needs of the 21st century? 5. Can separate statutory and GAAP systems continue to coexist? 6. Will the United States regulatory environment reduce our global competitiveness? 7. Variance analysis - Why your predictions were wrong - Which variances are acts of God? - Which variances should be blamed on somebody? - How to deal with interest rate fluctuations 8. Market valuation, why? - What questions are being addressed with market valuation

Description: Based on interviews with C-level executives, this report offers insights on the role and actions of the global insurance industry in addressing climate change

Description: Although rate structures where low-cost cohorts subsidize high cost cohorts may be justified from a actuarial, marketing, or legal standpoint, the subsidization creates risks which must be understood and monitored. This article presents the concept of subsidization signature to measure and interpret the effects of rate subsidization, and to assess the sustainability of rating structures and the sensitivity of business mix assumptions.

Description: This article delves into a new line of statistical thinking of the author, that may be useful for product development actuaries. The key concept is how product design can produce products that diversify quickly, meaning that the company can be confident of a profitable product line, based on fewer sales than might be true for other designs.