Description: The SOA Research Institute Catastrophe and Climate Strategic Research Program released a report that explores the shifting geography of Lyme Disease in the U.S. and beyond and some of the potential determinants of its spread. Lyme Disease is a well-known disease particularly in the eastern U.S., and it is also prevalent in other geographies. This report researches the complex relationship between climate variables and the spread of Lyme Disease in the United States.

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

Description: ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates. If risk adjustment methodology is not bridging that gap & becomes an additional input to pricing formulae, it is not serving its intended purpose.

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: Social Insurance & Public Finance Section council members provide a recap of sessions from the 2021 SOA Health Meeting, with a focus on sessions covering Medicare, Medicaid, the ACA, and public policy. The authors include a description of SIPF Section-sponsored sections, including a session on the ACA and a session on CMS's Direct Contracting Model.

Description: Actuaries have the business acumen, problem-solving capabilities, and technical skills to develop innovative and data-driven solutions in the social insurance space. It is time we expand our scope and embrace an increased role in making a positive impact within the health care ecosystem. The primary focus of this paper is on social insurance programs dedicated to the most vulnerable population: low-income families accessing care through Medicaid. While there are numerous challenges that require other subject matter experts to take the lead, this article highlights topics where actuaries can be key players in developing and implementing tangible solutions to improve the care for the most vulnerable. Issues and solutions in this paper focus on the following three areas: 1. Access to appropriate care, 2. continuity of care, and 3. social determinants of health.

Description: Overview of call center and digital sales platforms for the development of distribution strategy in the individual insurance market.

Description: A report analyzing the cost of care for deceased cancer patients over the last six months of life.

Description: This document is a Request for Proposals (RFP) outlining a proposal request on the impact of the U.S. drug abuse epidemic on mortality, focusing on opioids. It provides details on the background, purpose, research objectives, proposal requirements, selection process, and conditions for submitting a proposal.

Description: A research report describing aspects of provider network performance in health care settings with particular focus on experiences with Exchanges.