Description: Risk adjustment (RA) is a key component for CMS Medicare Advantage program and California Medicaid Managed Care program. While both RA programs follow generally accepted basic principles at a high level, their underlying methodologies and assumptions are also quite different. Due to recent events such as COVID-19 Public Health Emergency and Medicaid redetermination delay and restart, it adds complexity to Risk Adjustment. This is a hot topic in the industry and has significant impact to health plans. Keeping current with risk adjustment program changes and understanding the commonalities and differences of these two government risk adjustment programs is important to our health actuaries. Compare these two risk adjustment programs so you can learn key elements of a risk adjustment program, similarities and differences in methodology and assumptions , as well as special considerations due to serving different populations.

Description: Join us for a lively discussion on how accelerated underwriting (AU) practices have evolved over time and specifically because of COVID-19.

Description: Can you answer the question, 'What are the chances we will lose more than $1 million?' without saying, 'It depends'? If you miss a projection, can you estimate the chances that the miss was due to random variation versus an incorrect projection? Listen in as presenters demonstrate how to answer these questions and others using total risk analysis. Total risk analysis includes quantifying both the random variation risk and the projection risk associated with actuarial functions like pricing and reserving. After attending this session, you will be able to describe total risk analysis and to apply to many health actuarial functions.

Description: In order for an organization to benefit from artificial intelligence/machine learning (AI/ML) models, it requires the involvement of different business areas. During this webcast, professionals from data analytics, audit and risk areas will address challenges and provide solutions for working together to develop, implement, use and risk manage AI/ML tools. Throughout the discussion, the presenters will discuss: • Defining and exploring the challenges and objectives between data scientists, domain experts and control functions • Risk management – model risks and other risks • End-to-end model validation • Model performance vs. interpretability/understandability trade-offs • What to audit – auditor’s challenge and solutions

Description: Eager to learn more about what an InsurTech is, how they operate in the insurance ecosystem and how actuaries can participate in this ecosystem? Join actuaries, InsurTechs and participants in the ecosystem to discuss the recent research report on InsurTechs by the SOA. At the conclusion of the session, attendees will be able to: • Know more about InsurTechs and how they operate • Understand how insurers work with InsurTechs • Discover how actuaries can participate in this ecosystem • Learn practical lessons from both InsurTechs and actuaries This session is presented by the Entrepreneurial & Innovation Section.

Description: Hop into a panel discussion between InsurTech Advisory Council and a startup, followed by a demo of life event prediction and analyses with multiple applications across financial services. You will also learn about: the SOA office hours program and member participation, the startup ecosystem filled with incubators, company contests, opportunities and outcomes, how to build a data set providing additional insights for customization and enhanced user experience, and - actuaries' engagement with startup strategic advisory boards.

Description: Regression to the mean (RTTM) is inflating your health care intervention evaluations if you are not carefully managing it's omnipresent and significant impact RTTM is the statistical phenomenon which arises when comparing sequential data points when an initial observation is extreme or an outlier, and states that with no other intervention, future observations will be closer to the average. Members who had high costs last year will, on average, have lower costs this year, even in the absence of any intervention or clinical program, simply by 'regressing' to the mean. This means that if your clinical programs are simply targeting members who had adverse medical experience last year, you’re targeting the wrong people. And if your savings methodologies are simply last year’s costs minus this year’s costs, the savings are inflated. By attending this session, you will be able to identify situations where RTTM will be a significant factor, how to eliminate it's impact when performing retrospective evaluations, how to identify prospects for clinical intervention with RTTM in mind, and more.

Description: Further explore the pipeline of large claims approaching in the future in this webcast. Some of these upcoming claims include Cell and Gene Therapies, as well as high medical costs. In order to prepare for the multitude of claims, this session provides the insurance industry with an overview of what these large claims consist of. You can also expect important recommendations on how to properly prepare for them to succeed in this market.

Description: This webcast will walk through several statistical methods for imputing race and ethnicity from U.S. datasets, highlighting their strengths and weaknesses, talking about how to use them and evaluating their accuracy, and telling you where you can get code packages as well as a free dataset to try the methods out.

Description: "A crucial importance in forecasting is to be able to distinguish cases when temporary slowdowns in health care utilization are followed by a “rebound” period of higher utilization. Come explore an analysis of a new mathematical model describing the return-of-care process. By means of simulation and case studies using the R programming language, the relationship between the visibility of these effects and the endogenous variance of the utilization time series is explored. After attending this session, you will be able to: Describe the parameters and mathematical form of the model Apply the model to real-world utilization data"