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: On August 15, 2018, the FASB issued Accounting Standards Update 2018-12, Targeted Improvements to the Accounting for Long-Duration Contracts ("LDTI"). With its effective date, January 1, 2021, approaching fast, companies have begun the implementation process to prepare for this significant change. The three webcasts below will outline operational implications resulting from data and technology challenges.

Description: In year’s past, we presented the Practical Predictive Analytics Seminar (PPAS) as an add-on to the Life and Annuity Symposium or attached to the Predictive Analytics Seminar, this year it will take place as a stand-alone virtual Seminar.

Description: Is your development team or IT staff growing tired of last-minute requests to include additional functionality? Have you strained to explain challenging actuarial topics to non-actuarial staff for implementation? Do your teams find themselves revisiting deadlines & timelines when building solutions? During this interactive panel discussion, three technologists (two software engineering managers and one data scientist) along with three actuaries will discuss real world problems and approaches using experience from previous projects. Although the challenge of running efficient software teams is not unique to actuarial science, this webcast will discuss best practices on how to organize teams to reduce friction and context switching. Presenters will also explore unique actuarial challenges and concepts including how to address standards on data quality when building software, how to build intuitive software that meets actuarial standards and how test-driven development makes it easier to meet actuarial standards of practice.

Description: Data visualization is a hot topic within the industry. This session will showcase business use cases of data visualization models to build, for example, a claims trend story from outlier analysis to root cause in real time. There are many different ways to assemble pie, bar, or other types of charts, but critically understanding the business questions and following visualization best practices can accelerate the pace of identification to actionable result. Additionally, moving up the analysis continuum from busy Excel files with thousands of numbers to automated Tableau dashboards highlighting only the most impactful numbers with full drill-in capabilities improves both efficiency and communication to non-technical audiences.

Description: This paper introduces actuaries and others to dynamic stochastic general equilibrium (DSGE) models, a type of macroeconomic model. Authored by Kailan Shang, the paper illustrates how DSGE models can be used in economic scenario generation to reflect the cause and effect relationships that occur in the economic system.

Description: The Society of Actuaries' Pension Section and Health Section Research teams originally commissioned Professor Thomas E. Getzen of Temple University to construct a resource model for the projection of long term healthcare cost trends. The Society of Actuaries continues to make annual updates to the model to ensure its usefulness and relevancy.

Description: The aim of this research is to survey emerging data analytics techniques and discuss their evolution and growing use in the actuarial profession. Data analytics’ applications in life and non-life insurance will also be provided.