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: A news release announcing the winners of the 2024 Student Research Case Study Challenge.

Description: Renal disease is a very heterogenous medical condition whose end state is dialysis, a recurring cost intensive medical condition. Dialysis cost is one of the major medical cost drivers in USA. Insufficient and improper care management in the early stages of CKD (chronic kidney disease) leads to early incidence of end stage renal disease (ESRD) among CKD patients which not only leads to high medical costs, but also reflects poor health quality.

Description: The key tasks of credit risk capital project under CROSS II mainly focus onL(1 )Adjustment of measurement framework; (2) Calibration of risk factors, including both credit spread risk and credit default risk;3)Introduction of concentration risk measurement; (4) Higher requirement on look-through rule.

Description: This is the second part of a 2 part series on Real options analysis (ROA). This article looks into the limitations of using financial option theory when doing real options analysis with projects that are long-dated and uncertain, such as: 1. First-degree homogeneity, 2. Uncertainty must derive from Brownian motion, and 3. Risk neutrality.

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: 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 Society of Actuaries (“SOA”) Research Institute is the research arm of the SOA, providing objective, data-driven research that brings together tried and true practices and future-focused approaches to address societal challenges and business needs. The Institute provides trusted knowledge, extensive experience and new technologies to help effectively identify, predict and manage risks.

Description: Since the international financial crisis, accounting standards have become an important part of financial supervision rules, which objectively requires us to study the reform and development of accounting standards from the perspective of financial stability. Since the release of IFRS17 in 2017, the research and discussion of IFRS17 in the insurance industry has focused on technical details and implementation, while the economic impact and pros and cons analysis of IFRS17 are few. As a result, the industry's understanding of IFRS17 is not comprehensive enough, and there are still many disputes, and no industry consensus has been formed. In the future, the insurance industry should strengthen the research and analysis of IFRS17 from the perspective of financial stability, deepen the understanding and cognition of IFRS17, and improve the ability to control and use IFRS17.

Description: This article is the first installment of a three-part series that aims to provide an overview of ESGs and will focus on the general motivation for stochastic modeling, its advantages and its limitations. Future articles will further break down the key factors of ESGs and the application of these factors to better understand the Academy Interest Rate Generator (AIRG).