Description: Risk adjustment in government regulated health plans has been around for over two decades. Yet the strategies for promoting risk score accuracy haven't varied much during that time. Most health plans, physician groups, and vendors promote chart reviews and/or in-home assessments as the primary vehicle for collecting data not perceived to be present in the routine claims submission and adjudication stream. We know that most organizations trying to coalesce encounter data from multiple sources often fail to ensure that all relevant data is ultimately submitted to CMS or a state Medicaid agency. Crucial data, often with significant financial value, frequently gets lost in the data pipeline, somewhere between the provider's billing system and the health plan and/or its vendors. Because 837-formatted data is difficult to read, it complicates payers and vendor’s abilities to track encounter data so that every service delivered to patients is credited to the applicable risk adjustment formula. It is incumbent upon successful risk-adjusted entities to be able to track encounter data, identify processes and/or vendors which may be mangling or losing data, in order to ensure that risk scores are sufficiently accurate to be compliant with plan sponsor requirements and to ensure appropriate revenue to the health plan or provider group.

Description: Learn how modernization of data, models, and technology are influencing workflows. This webcast will address how workflows are changing in response to new regulatory requirements and the impacts the changes have on modeling and end-to-end future state operating models. Industry leading actuaries will discuss: How team collaboration can increase quality and speed of reporting to internal and external stakeholders How to strengthen controls and compliance frameworks across finance and actuarial departments How to modernize actuarial input/output for strategic analysis and insights How to attract and retain top talent by improving opportunities for actuaries There will also be dedicated time to ask questions of those who have made the transition.

Description: Discussion of a newly released LTC experience study, including description of data and its increased scope compared to the prior report, reporting specifications, and findings.

Description: Innovation in technology has disrupted nearly every industry, creating mounting internal and external pressures on organizations to accelerate the adoption of their digital agendas. The COVID-19 pandemic further brought to light the need for tools and technology to be adaptable, powerful, and scalable. As the insurance industry leaps into the future, actuaries must not only proactively refine their roles and responsibilities within insurance organizations but also seek opportunities for improvements and optimization in their day-to-day work. Discuss a variety of opportunities to streamline, accelerate, and optimize actuarial processes by using modern technology. Cover a wide spectrum of actuarial solutions from automation of actuarial data transformation to actuarial reserve calculations and calibration of economic scenarios. By attending the session, you will: Be able to articulate how modern low-code/no-code technology can help actuaries automate, streamline and optimize processes in yourday to day work tohelp focus on higher value tasks.

Description: Level funded products often target the small group market (2-50) and can result in many manual and tedious processes for underwriting to perform risk assessment. Learn how a carrier used technology to help automate risk assessment without the need for paper medical questionnaires, and exposed a risk engine for broker quoting to enable near real-time of pricing for risk-based products. The approach reduced labor and allowed underwriting to focus solely on fallout cases while also improving pricing consistency. Discuss broader trends in the health market for risk assessment, including new machine learning cost predictions that can be used for automation and better predictions of future costs. Discussion topics will include underwriting guidelines, business rules, risk scores, and machine learning. By attending this session, you will have a better idea of new trends in risk assessment for small groups where no claims experience is available. And, better understand business rules that are common in underwriting for flags for review as well as how risk scores and machine learning can be used during the underwriting process.

Description: This is a presentation of recursive APL programs for Steffenson's and Romberg's algorithms. The programs call themselves repeatedly until terminating conditions are reached. From the Actuarial Research Clearing House ARCH 1987 Vol. 1.

Description: Ever wanted to do a Kaggle data science competition, but didn't know where to start? This presentation meets the needs of actuaries interested in predictive analytics and competitive data science. The presentation will describe the nature of competitive data science, and provide insights into lessons learned by competing in the Airbus Ship Detection Challenge at Kaggle, as well as other Kaggle competitions. The presenters will provide an introduction to neural networks and describe the nature of the Airbus Ship Detection Challenge and other Kaggle competitions, plus a solution approaches that can be used to obtain top scores using Convolutional Neural networks (CNNs), random forests and boosted trees.

Description: Feature article describing what author thinks it will take for a life insurance company to be successful in the year 2020.

Description: This article looks at an extensive integrated collection of financial mathematical modeling packages available in R, a language and environment for statistical computing.

Description: Asset liability management is an important task for any insurer, where tools like Excel play an important role from an analytics perspective. Dashboard tools like Power Bi and Tableau can supercharge an organization’s ability to perform ALM with real-time precision and monitoring of risk/imbalances. The dashboard can provide insights into potential risks posed by asset allocation and concentration, allowing for informed decision-making to mitigate those risks. The presenters will walk the audience through an example of ALM use case, including how to build key performance indicators such as cash flow, asset allocation, and risk exposure. Additionally, we will demonstrate how these types of dashboards can be customized to fit the specific needs of your organization.