Description: This discussion at the SOA 1997 Palm Desert Spring Meeting looks at issues related to second-hand smoke including the negative health effects and underwriting implications.

Description: The presenters will explore the roles of mental health and social determinants of health in the management of a population's total health. We will explore how emerging sources of data and information have led to a renewed focus on managing mental health conditions and social determinants of health. Speakers will address current health care programs that utilize this data and information to manage the total care for populations using predictive models to improve the deployment of resources and initiatives to improve the cost of care and health of populations. The presenters will also look at how providers of care are approaching mental health co-morbidities to manage physical health and social determinants of health in the management of patients.

Description: Presented at April 1986 Spring Meeting. This session discussion is about the impact of wellness programs on medical plan experience/non-medical plan experience, health status as a pricing variable, likely future developments.

Description: Presented at October 2001 Annual Meeting. Discusses three key factors related to catastrophic health care events: • Trends in health care delivery and medical technology that are likely to impact catastrophic care costs • Methods of cost and risk control through early identification and specialized medical management • Modeling the cost of catastrophic events on health insurance programs

Description: This 1981 session dealt with Risk Classification for Individual Health Insurance. Topics included current legislative/regulatory trends and their impact on pricing and plan design, high risk-sharing pools, and deomographic considerations. From Record of Society of Actuaries 1981 Vol. 7, No. 2.

Description: Statement of the American Council of Life Insurers on Pandemic Influenza Preparedness in the Financial Services Sector before the Subcommittee on Oversight and Investigations of the House Financial Services Committee of the United States Congress, June 29, 2006

Description: The proposed session will introduce Outcome Based Risk Sharing Arrangements (“OBRSA”) between health insurance payers (“payers”, including insurance companies, health plans, sponsored employers, and government programs) and pharmaceutical manufacturers (“pharma”), and it’s intended to meet the needs of actuaries who focus on pharmacy benefits and risk sharing arrangements. The covered content will include (1) the background of OBRSAs, definitions, stakeholders, and OBRSA’s role in shifting the system from volume-based toward value-based; (2) conflicting perspectives about OBRSAs between payers and pharma (cultural and methodological); (3) identification of incentive gaps between payers and pharma, and incentive alignment between them; (4) barriers to implement OBRSAs; (5) limitations and considerations of OBRSA implementation; and (5) hypothetic OBRSA examples.

Description: This session is about health risk adjusters and includes a discussion on risk assessment, actuarial applications, New York small-group reform, medical management applications, Rand 36, and other methods. From Record of Society of Actuaries Vol. 19, No. 4B.

Description: The advent of machine learning algorithms has taken predictive analytics and risk scoring to a new level. From gradient boosting machines to k-nearest neighbors regression, the use of these techniques has gained significant traction in healthcare - including health systems like the Cleveland Clinic. This session will discuss the use of predictive analytics to go beyond just assessing the risk of a patient, and instead focus on prescribing a specific intervention of care. In practice, the recommendation of a care plan goes beyond just attributing a score to a patient. It provides physicians and care coordinators the most probabilistic options - e.g. referral to social worker, depression screening, weight-loss program - for positively impacting a patient's future healthcare outcome.

Description: This session discusses the benefits of actuarial involvement in understand. Topics include current methods [such as teleunderwriting, use of pharmacy data] and the benefit versus cost of using various underwriting tools. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 22