Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: 2021 ImpACT Conference - Session 4B: Post-COVID Strategies: Connecting Pandemic Outcomes, Health Equity and Fiscal Sustainability 10.26.21 Recording

Description: 2021 ImpACT Conference - Session 1E: Transforming Group Underwriting Using Artificial Intelligence and Machine Learning 10.25.21 Recording

Description: 2021 ImpACT Conference -Session 8D: SOA Health Actuarial Research Update 10.27.21 Recording

Description: The level-funding approach to medical stop-loss insurance is growing in popularity, yet is highly specialized. This session will give the actuarial community an overview of level-funding, including the basic mechanics, the benefits of offering level-funding to clients, and the five keys to success, including the ability to underwrite this specialized coverage.

Description: This article is intended to inform readers about the current state of mental health and health care in the US, as were it's heading moving forward.

Description: Discover the impact of COVID-19 on member costs post diagnosis and the future of mortality in this Emerging Long Term COVID-19 Trends webcast. This webcast will be split up into Health and Life portions. During the Health portion of this webcasts, you will learn more about the impact on risk scores due to recent findings. Enjoy this discussion and further dive into the emerging COVID-19 trends that may affect how you conduct business practices. At the Life portion, the SOA Research Institute assembled a panel of mortality experts who will express opinions on the effects of the U.S. mortality rate for general, insured and pension populations in the short-term.

Description: The National Association of Worksite Medical Clinics reported that one-third of U.S. employers with 5,000+ employees sponsored worksite (onsite) health care centers in 2017, and 24 percent of employers with 500-4,999 either have or plan to implement onsite health care by 2019. This session will explore why onsite health care programs are gaining traction: • Why do employers sponsor onsite healthcare? • What objectives do they hope to achieve? • How does the evidence compare with these objectives?

Description: Critical illness insurance is a popular supplemental health insurance product in the U.S. market. This article discusses how carriers have recently sought to add value by expanded the benefits offered in their critical illness products. Specifically, the article discusses the consumer need and development considerations of adding benefits for autism Spectrum Disorder, Mental health disorders, Specified Disease Coverage, and enhance Cancer Coverage to a critical illness contract.

Description: "Risk adjustment is an important aspect of establishing appropriate capitation rates. When a set of services is carved out for specific management under a sub-capitation, establishing appropriate adjustments for varying levels of underlying risk is more complicated. Dive into analytical and operational challenges and resolutions as presenters share more about developing a risk adjustment model specific to the carve-out of behavioral health services through a real-life case study. You will further explore a definition of the use case, availability of historical data sets, selection of the modeling approach, learnings from the iterative modeling process, and the potential application of the results. After attending this session, you will be able to: Understand why a behavioral health specific-risk adjustment model has business value Understand the unique challenges related to developing risk adjustment on member and cost subsegments Understand the impact of trade-offs between model complexity and interpretability in the context of implementation Increase awareness of data nuances and requirements unique to this type of project Describe analytic techniques that can be investigated for use in projects of similar business objectives"