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Better Care Through Understanding the Customer Not Just the Patient
actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical ... small fraction of their time in these facilities. This article explores what types of data are available ...- Authors: James Dolstad, Craig Cartossa, Justin Hartmann
- Date: Dec 2021
- Competency: Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Health & Disability>Health risks; Health & Disability>Payment models; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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The Future of Actuarial Models
The Future of Actuarial Models A look at the near future and far future of various elements of Actuarial ... Models as defined through ASOP 51. What is driving the complexity for inputs, calculations, and outputs ...- Authors: Nathan Worrell
- Date: Jul 2022
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Actuary of the Future
- Topics: Technology & Applications>Analytics and informatics; Technology & Applications>Software; Predictive Analytics>Modeling techniques; Technology & Applications>Artificial intelligence & machine learning
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Actuarial Open Educational Resources
article advocates creation of open educational resources (OERs) that will benefit the actuarial profession ... retention of members. Specifically, we describe OER contributions made at the University of Wisconsin-Madison ...- Authors: Edward Frees, Paul Herbert Johnson, Marjorie Rosenberg
- Date: Nov 2021
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Expanding Horizons
- Topics: Actuarial Profession; Actuarial Profession>Professional development; Predictive Analytics; Predictive Analytics>Modeling techniques
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Incorporating Random Effects to Reduce Variance in Risk Score Estimation
Effects to Reduce Variance in Risk Score Estimation Traditional risk scoring models include only fixed ... condition-based variables. By including the provider effect as part of the risk scoring model as a random effect ...- Authors: Robert Jason Reed (Jason)
- Date: Jul 2021
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Estimation methods; Modeling & Statistical Methods>Regression analysis; Predictive Analytics>Modeling techniques
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Give Me Some Credibility: Addressing the Challenge of Volatility in Value-Based Contracts—Part 2
Addressing the Challenge of Volatility in Value-Based Contracts—Part 2 Discover the key components of value-based ... their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique ...- Authors: Maria Knox, James Pisko, Keith Passwater
- Date: May 2023
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance; Predictive Analytics; Health & Disability>Provider networks; Health & Disability>Provider risk; Predictive Analytics>Modeling techniques
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Adapting Credibility Blended Rates to Encompass Machine Learning Predictions
Machine Learning Predictions Actuarial concepts of credibility can be extended to encompass additional ... information. For example, historical claim costs and risk scores both leverage diagnosis code information ...- Date: Apr 2021
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Predictive Analytics>Modeling techniques
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When Affordability Savings Do Not Reduce Costs
Affordability Savings Do Not Reduce Costs Regression to the mean is a phenomenon that arises when comparing sequential ... closer to the average. Health care actuaries need to understand and be able to mitigate the effects of regression ...- Authors: Tony Pistilli
- Date: Dec 2020
- Competency: Results-Oriented Solutions; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Modeling & Statistical Methods>Forecasting; Modeling & Statistical Methods>Regression analysis; Predictive Analytics>Modeling techniques; Predictive Analytics>Quality control & model governance
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Government Sponsored Health Actuarial Initiatives in Colombia
Colombia Highlights of two 2018 health events organized by the Colombian Association of Actuaries and sponsored ... sponsored by the Colombian Government. Seminar on Risk Adjustment and Predictive Modeling in Health. Seminar ...- Authors: Armando Zarruk
- Date: Nov 2019
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: International News
- Topics: Health & Disability>Health risks; Predictive Analytics; Predictive Analytics>Modeling techniques
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Gaining Trust in Predictive Models—an Actuarial Perspective
Actuarial Perspective This article provides an overview of activities that should be considered by an actuary ... provides an examination of various methodologies that can be implemented in the validation process. By ...- Authors: David Alison FSA (David)
- Date: Sep 2021
- Competency: Communication; External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: The Financial Reporter
- Topics: Predictive Analytics>Modeling techniques; Predictive Analytics>Quality control & model governance; Technology & Applications>Artificial intelligence & machine learning
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Modeling Extreme Events
A significant fraction of insurance risk is characterized by the tail of the claims distribution, where ... Ignoring the tails can lead to underpricing of tail risk and mispricing. Estimation of the tails can ...- Authors: Robert Jason Reed (Jason)
- Date: Jun 2021
- Competency: Technical Skills & Analytical Problem Solving
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Predictive Analytics>Modeling techniques