Description: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care

Description: Diabetes mellitus type 2 is an excellent model for assessing the setup of medical coverage in the U.S. health care system. It is a chronic disease that has genetic, behavioral and other medical causes, and causes many complications over the long term. From Financing Chronic Care Monograph, M-HB05-1.

Description: Excel file containing extracts of utilization and costs for chiropractic and acupunture - females. From a research project examining the utility of standard eligibility and claims extracts for complementary and alternative medical therapies - CAM analysis.

Description: Excel file containing extracts of utilization and costs for chiropractic and acupunture - females. From a research project examining the utility of standard eligibility and claims extracts for complementary and alternative medical therapies - CAM analysis.

Description: Summary of the 1974 report of the HIAA Prevailing Health Care Charges System which contains data from about 900,000 charges for up to 1,600 different surgical procedures, summarized for 250 geographical areas. From The Actuary Vol. 9, No. 7

Description: Discussion and Opinion on how randomness affects measurement of provider contracting risk-sharing agreements

Description: Excel file containing extracts of utilization and costs for chiropractic and acupunture - all members combined. From a research project examining the utility of standard eligibility and claims extracts for complementary and alternative medical therapies - CAM analysis.

Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.

Description: Excel file containing extracts of utilization and costs for chiropractic and acupunture - males. From a research project examining the utility of standard eligibility and claims extracts for complementary and alternative medical therapies - CAM analysis.

Description: This article provides an overview of behavioral economic theory as it relates to health and welfare insurance plans and provides summaries of two sample applications of the theories: enrollment in health insurance exchanges created by the Patient Protection and Affordable Care Act, and product design considerations in light of vast health illiteracy.