Description: The last three decades have witnessed an important rise in number of people with diabetes in Asia, especially Type 2 Diabetes. Like no other common condition, numerous innovations are currently entering the healthcare system that will soon have a significant impact on management of the condition. This presentation explores the role played by sensors/wearables, artificial intelligence, new drugs and diabetes apps. We assess the realistic potential of such advancements and give an outlook on medium-term pricing and product development.

Description: In Medicaid rate development, actuaries have not historically shared models that developed the margin (i.e., underwriting gain) assumption. This is unfortunate, given the margin assumption is one of the most critical components of the rate development in ensuring financial solvency of the Medicaid managed care organizations (MCOs). In this session, we will discuss the primary components of the this assumption and will share working models that help actuaries quantify these components—including the cost of capital and risk (or contingency) margin. We expect a lively discussion as we “open the black box” and discuss these actuarial assumptions in the public for the first time.

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: While medical and pharmacy claims data is a well-established source for healthcare analytics, significant data can be found elsewhere in electronic medical records (EMRs) and in hospital admit, discharge, and transfer (ADT) messages. Increasing availability of bulk EMR data to analyze coupled with more powerful and specialized tools for analyzing it presents an opportunity for actuaries to incorporate these sources in their work. This session will take a look at some of the data available beyond claims in EMRs and HL7 ADT messages, and will discuss case studies, with consideration around structure, ease of use, cleanliness, and tools available for analyzing these data types including natural language processing.

Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.

Description: After the bid process, desk review, rebate reallocation, an “enjoyable” audit, and open enrollment; the Medicare plan year starts. Throughout the year, organizations find it pertinent to get an accurate picture of their Part D liability as reinsurance, LICS (Low Income Cost-Sharing) subsidy, and risk corridors are accrued. Attendees will learn about the basics of Part D accruals, how future accrual amounts are estimated based on patterns in the data, and how bid assumptions versus actual results impact plan sponsor profitability. We will also discuss financial statement treatment of these items. Real-life examples from bids to outcomes will be provided to enhance the discussion. Ultimately, attendees will come away with a deeper understanding how their bid assumptions play out, and how they can use Part D accruals to plan for future bid development.

Description: "Visual storytelling is frequently used to effectively convey complex actuarial concepts to our clients and other audiences. When talking about data visualization, we often focus on the explanatory aspect. But data visualization is also a crucial tool in developing insights from large and complex data sets at every stage of data analytics spectrum: • descriptive (what happened?), • diagnostic (why it happened?), • predictive (what will happen?), • and prescriptive (how do I influence what will happen?). In exploratory and modeling stages of data analytics’ project, we let the data tell the story or explore our intuition and hypothesis through data pictures. We demonstrate the power of visual display in healthcare data analytics through vivid examples from the healthcare case studies. These illustrations of data visualization exploratory power range from assessing the quality of data or examining outliers, to exploring variables’ relationships and trends, to hypothesis testing, to guiding in feature selection and models’ comparison and evaluation, to model validation. Throughout these illustrations, we will discuss principles of graphical effectiveness, excellence and integrity."

Description: Through much of the Baby Boomer generation's working lifetime, retirement planning focused on asset accumulation. Strategies like Dollar-Cost Averaging and Asset Diversification became well understood by nearly everyone in the retirement industry. As those assets move into the payout phase (post retirement), the appropriateness of those strategies becomes less clear. Presenters will aim to exhibit and explain how and why adding a Single Premium Immediate Annuity (SPIA) or Deferred Income Annuity (DIA) to a retirement portfolio can help to minimize a retiree's chance of outliving his or her income, and why sellers of annuities should focus more heavily on these product offerings. At the conclusion of the session, attendees will be able to - Identify the reasons why effective asset accumulation strategies may be ineffective in the decumulation phase of retirement - Evaluate the benefit of using at least a portion of accumulated retirement assets to purchase a fixed income stream that the annuitant is guaranteed not to outlive - Explain the benefits of a SPIA/DIA focus to other industry practitioners

Description: This session will cover lessons learned during the course of implementing PBR by the panelists. It will focus on areas that were difficult to interpret, unexpected issues and managing the process. It will focus on potential stumbling blocks from an implementation, pricing and product development standpoint. There will also be an overview of YRT treatment to date and an update on any emerging best practices.