Description: As actuaries in health care, we spend most of our time focused on reviewing claims, enrollment and clinical data. That information is captured while patients are in health care facilities. Yet most people spend only a small fraction of their time in these facilities. This article explores what types of data are available to actuaries the provide a more holistic view of the member so that a members physical and emotional needs, the social determinants of health can be taken into consideration along with their clinical needs. Two uses cases are presented so actuaries can see how these types of analyses can be leveraged to improve clinical, operational, and financial performance of risk bearing health entities. Understanding the customer (member) not just the patient enables actuaries to provide new insights and values to our stakeholders across a wide range of business and risk applications.

Description: This session will explore the various contracting techniques that CMS, providers, and employers are using to achieve their strategic objectives across both the Commercial and Medicare markets.

Description: Health care cost trends are a key ingredient that health care actuaries use in their practice. In collaboration with the Health Care Cost Institute (HCCI), the Society of Actuaries has put together a data extract for practicing health actuaries to be able to better understand historical trends and cost disruptors.

Description: This study would assess the impact of recent patient care innovation(s) on health care and the health insurance industry.

Description: What can the United States learn from other countries' health care systems? How are other countries more efficient? We selected five countries that have been among those debated as having some of the most efficient health care systems to explore what the United States can learn from these examples.

Description: The Patient Protection and Affordable Care Act (ACA) was signed into law March 23, 2010. The transformative health care legislation was multi-faceted, but its primary purpose was to reduce the number of uninsured Americans. In alignment with the SOA’s Strategic Plan objective to “inform the public’s understanding of key societal issues”, this report examines the various publications reporting on the uninsured rate which stakeholders frequently access to measure policy efficacy and inform future policy considerations.

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

Description: Data file for Commercial Health Care Cost and Utilization Trends From 2009–2015 research report.

Description: As part of an upcoming Society of Actuaries (SOA) research release to model health care costs in 2020 and 2021, a set of “Return Stages” were created in order to define the various level of activities being observed, as well as to contemplate the ways these stages may progress as various cities, counties and states release their own phasing processes for returning their jurisdictions to normal.

Description: Through the sponsorship of the Robert Wood Johnson Foundation, The Society of Actuaries partnered with Wakely to use their health care data to study the effects of COVID-19 on overall health care claims for individuals with a COVID-19 diagnosis. The conclusion of the study is that individuals with COVID-19 claims had significant increases in health care costs leading up to their months of diagnosis, as well as in the months following their diagnosis. These effects were more pronounced for individuals who were hospitalized due to COVID-19 as well as for individuals with prior co-morbidities. Finally, the overall health care costs of these members plateaued at significantly higher levels than their pre-COVID baselines. In fact, all the main membership cohorts experienced claim levels that were at least 20% higher than their pre-COVID starting points.