Description: This session discussion is about the profitability outlook, both long and short term, for various health coverage related products such as: HMOs,, Small group insurance TPAs and ASO, Individual medical, and Individual disability income. From Record of the Society of Actuaries Vol. 14, No. 4A.

Description: The focus of the webcast on Modeling Long–Term Medical Trends for Valuation Purposes was a discussion of the underlying methodology of the model, a walk through of the actual model, and a review of the considerations for its practical usage by actuaries. The running time of this video is 1 hour and 3 minutes. It is a presentation of slides without audio.

Description: This project shows how to use agent-based models to simulate the behaviors of agents in complex health systems.

Description: Early in his career, Ehren Nagel, FSA, MAAA, scoured through podcasts and articles about predictive analytics, long suspecting this was a field with potential for him.

Description: This report evaluates alternative payment models that potentially could be instituted by healthcare payers and manufacturers.

Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.

Description: This session will describe best practices for the preparation of the actuarial memorandum that supports the statement of actuarial opinion that is part of a health annual statement and review highlights of the new (2019) practice note on this topic. Presenters will represent different perspectives to discuss the components of an actuarial memorandum and use examples to present best practices and practical application of the information presented in the practice note.

Description: Strategies to position Medicare Advantage plans for success during August resubmission.

Description: Financial reconciliation is critical to a successful Medicare Advantage (MA) bid. Reconciliation should be routinely revisited as new information arises.

Description: This article talks about forging relationships between Health actuaries and CMS. Issue No. 60