Description: New digital data known as alternative data is everywhere. Our industry has seen the financial, and hi-tech industries leverage new digital data to expand their key offerings and core services. From the lens of the global life and health industry, new digital data is still searching to be further understood. Risk assessment is a current focus area for using alternative data. A key question is even though risk assessment has always been data-driven, can it now move to the next level with the arrival of this alternative data. Can we use alternative data to make the risk assessment process quicker, cheaper, or faster thereby driving more sales and better conversion rates. It is an exciting time! With the increased adoption of health and well-being apps, data such as physical activity, nutrition, sleep, and mental wellness is now readily available. Expanded data such as digital biomarkers, IoT data, electronic health records and many more can also be accessed. However, how to effectively implement alternative data remains a challenge across the industry. We firmly believe it is, and will continue to be, imperative to take a structured approach to alternative data through a set of key considerations and a framework of principles.

Description: Presents a step-by-step methodology for calculating confidence intervals for IBNR estimates derived using the Averaqe PMPM method. It is a companion article to the January 2023 Health Watch article presenting the Average PMPM method for generating point estimates of IBNR with zero claims runout.

Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: The COVID-19 pandemic helped accelerate many changes in the Health Care system that were already taking place. The major disruptions to the way providers operated was quite evident with shifting of focus away from elective services to create capacity for treating COVID-19. However, even before the pandemic, providers were adapting to changes in their environments.

Description: Telehealth benefits, obstacles, and delivery systems

Description: The article focuses on the policyholder tax considerations specific to various types of contracts sold by life insurance companies. When evaluating merger and acquisition or reinsurance transactions, buyers need to be aware of the product tax compliance (PTC) requirements and evaluate any associated risks

Description: 2011 Enterprise Risk Management Symposium, Chicago. This study investigates whether simulation-based models can be used to predict liquidity risk for banks, which must comply with Basel III by January 2015. The paper looks at the process of developing a measurement framework using Black-Scholes and Merton’s asset-based models to measure liquidity risk.

Description: 1998 Valuation Actuary Symposium. The panelists discussed applying economic scenario generators in the life insurance business, a particular generator that has been developed at SS&C Technology Company, a way of reducing the number of scenarios to get the maximum amount of information, and what to look for in a software vendor.

Description: The momentum in value-based care has produced an opportunity for actuaries to become pioneers in health care

Description: Learn how medical coding, claims, data-sourcing and more are relevant to actuarial work in the health care field when you sign up for this SOA e-course.