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: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.

Description: This presentation introduces the concepts and methods of trend analysis and a developed an Excel Software package for trend analysis.

Description: Overview of a benefit rush and its effects on companies.

Description: This model arose from a project to evaluate the cost of a health care access' program to provide comprehensive medical care to uninsureds in Minnesota, for the Minnesota Health Care Access Commission. The project was to provide estimates of the impact on per-person and aggregate costs for various participation percentages in the access program. In order to evaluate those costs, the antiselection model described in this was developed. Of note, this was the ACTUARIAL EDUCATION AND RESEARCH FUND 1991 PRACTITIONERS AWARD WINNER. From Actuarial Research Clearing House 1991, VOL. 2.

Description: This article looks at the Return on Investment for Disease Management and highlights point to consider. From Health Watch Newsletter, May 2006, Issue No. 52.

Description: Response to March 2021 Practice Note on ASOP 6

Description: Prescribers, payers, and patients must put a higher priority on the comparative cost-effectiveness of competing pharmaceutical products if society is ever going to achieve rational and affordable drug use for all. From Prescription Drugs Monograph, M-HB04-1.

Description: SOA’s recently completed research project related to long term projects of health care cost trends for use in post retirement medical valuations.

Description: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.