Description: An essay suggesting a health care financing system.

Description: Editor's comments on the publication

Description: Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the impact big data and predictive modeling is having on the health care industry

Description: The ACA’s Medical Loss Ratio Provisions

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: Read the March 2017 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.

Description: Health Watch, Issue 79, December 2015, Health Watch

Description: Changes introduced by various Medicare Alternative Payment Models and the Medicare Access and CHIP Reauthorization Act (MACRA) have accelerated an existing market trend of shifting some of what has traditionally been considered “insurance risk” to providers. The Provider Risk Sharing Boot Camp will give attendees deeper insights into methods, current thinking, and alternative solutions that actuaries can use to help providers understand and manage the financial and actuarial risks that they are taking, many for the first time.

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: Read the February 2018 issue of Health Watch, published by the Health Section. Practical information for actuaries, articles impact sections, section activities.