A Comparative Analysis of Claims-Based Tools for Health Risk Assessment

Research Projects – Health


The Society of Actuaries Health Section is pleased to make available the following report that evaluates the predictive accuracy of commercially available claims-based risk assessment tools. The report builds on the findings from previous related SOA studies completed in 1996 and 2002.

The study was motivated by the continued growth and advancement in the use of health care predictive modeling since the 2002 study was completed. The report, written by Ross Winkelman and Syed Mehmud of the Denver office of Milliman, Inc. (Mr. Winkelman has since joined Wakely Consulting), provides a resource for organizations desiring to evaluate the appropriateness of the software tools for their needs.

Note: The Society of Actuaries does not endorse, explicitly or implicitly for any purposes, software packages evaluated in the study.

Milliman, Inc. has prepared a statement of reliance and limitations of the analysis.

A special printed version of the report will be available later this year.

As part of their participation in the study, software vendors were invited to provide formal comments on the study.

Acknowledgements

The Health Section Research Team would like to thank the following individuals who served on the Project Oversight Group for their time and valuable input.

  • William Lane, Chair
  • John Bertko
  • Tim Connell
  • Ian Duncan
  • Rafi Herzfeld
  • Darrell Knapp
  • David Knutson
  • Ken Lau
  • Bernard Rabinowitz
  • Craig Schmid
  • John Stark
  • Steve Siegel, SOA Research Actuary
  • Jeanne Nallon, SOA Research Assistant