Description: The panelists address Health Insurance Portability and Accountabuility Act [HIPAA] related concerns for health insurers, such as: implementation issues, privacy, transactions and code sets, employer identification numbers, and current developments relative to the pending rules. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 65

Description: Impact of Technology on Health Care Delivery Systems - Chart 3

Description: Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they review and use data for bid preparation

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: Essays show a new system that will encompass minor changes to the current health insurance system, it will allow consumers to sign up for Federal Employees Health Benefit Plan and be administered like Medicare but with more benefits and emphasis on preventive care.

Description: A Regulatory Perspective on Rate Review Before and After the Affordable Care Act

Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: Collective Health plan sponsors found that concierge services and enhanced digital tools produced lower trend by helping members navigate more intelligently.

Description: Summary of SOA initiative on preparing and positioning actuaries to move into new roles which are becoming available as the health care industry changes.