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: Discover the key components of value-based care (VBC) contracts and their impact on provider credibility. Learn about benchmarks, measurement period results, and the unique challenges providers face in managing insurance risk. Gain insights into reducing costs and aligning financial incentives in the US healthcare market.

Description: Often actuarial practitioners are faced with working with data that is less than ideal. The data may be observed with gaps in it, a model may suggest variables that are observed at different frequencies, and sometimes predictive analytic results are very fragile to the inclusion or omission of just a few observations in the sample. Data, particularly big data, are often "messy" and something must be done about it. What is the actuary to do about these very practical matters? These types of questions are what this presentation is intended to address. Concerns on missing data, outliers, nonlinearity, mixed-frequency, cross-correlations are illustrated using real datasets in the Asia-Pacific countries. Some possible solutions to the messy data problems will be discussed.

Description: Often actuarial practitioners are faced with working with data that is less than ideal. The data may be observed with gaps in it, a model may suggest variables that are observed at different frequencies, and sometimes predictive analytic results are very fragile to the inclusion or omission of just a few observations in the sample. Data, particularly big data, are often "messy" and something must be done about it. What is the actuary to do about these very practical matters? These types of questions are what this presentation is intended to address. Concerns on missing data, outliers, nonlinearity, mixed-frequency, cross-correlations are illustrated using real datasets in the Asia-Pacific countries. Some possible solutions to the messy data problems will be discussed.

Description: We compare two predictive analytics methods - GLM and GBM in terms of predictiveness vs. interpretability.