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: Many new and innovative companies are leveraging technology to improve the effectiveness of the care provided to patients. They are employing better tools to identify patients who can benefit from specific programs that best meet the patient's need. They are also dramatically increasing the use of these programs by guiding plan members through the maze of offerings to match them with the programs that will be most beneficial to them. Employers are making these third party programs available to their members and Medicare Plans are using these new tools to identify emerging health risks for early intervention and more accurate risk scoring. This session will explore some examples of these programs, how they are being effectively integrated into the operations of health plans and how the results of these programs are being measured.The speakers will be:Raj Behal, MD, MPH,Chief Quality Officer, One Medical. Raj leads the quality and safety, value and innovation, and data science teams at One Medical. One Medical is changing the way primary care is delivered with a concierge approach with technology seamlessly woven into their offering. This includes booking appointments on line, virtual face to face care, accessible medical records and health reminders.Mylea Charval,Ph.D., CEO and Founder, Savonix. Savonix is a next generation cognitive assessment platform that brings clinical, evidence-based, and all mobile digital assessment of cognitive and emotional function. These capabilities are critical for early identification of the onset of dementia and for the proper risk assessment of seniors enrolled in Medicare Advantage Plans.Ed Cymerys, FSA, Advisor. Ed will serve as moderator. Over the last six years Ed has served as an advisor to a number of early stage technology companies looking to improve the way health benefits are being delivered.Dave Sotelo, FSA, MAAA, Actuarial Manager, Collective Health, Inc. Collective Health is an integrated solution that allows self-funded employers to administer their health plans, control costs, and take care of their people -- all in one place. They have effectively integrated more than 70 distinct third party solutions for self-funded employers and are rigorously assessing the impact of these programs

Description: The last three decades have witnessed an important rise in number of people with diabetes in Asia, especially Type 2 Diabetes. Like no other common condition, numerous innovations are currently entering the healthcare system that will soon have a significant impact on management of the condition. This presentation explores the role played by sensors/wearables, artificial intelligence, new drugs and diabetes apps. We assess the realistic potential of such advancements and give an outlook on medium-term pricing and product development.

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

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

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

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

Description: Essential Health Benefits and Actuarial Value

Description: A discussion of insurance claims processing and payment systems, and how to achieve the minimum possible number of errors.

Description: This session presents information sources used in tracking health technologies, the value of health technology assessments and clinical data typically available. From the Record of the Society of Actuaries, Vol. 31, No. 2, Session 4

Description: This presentation from Session 111OF of the SOA 1999 San Francisco Annual Meeting covers the new medical technologies and how they affect the price of medicine, the delivery of health care, the cost of care, claims handling, utilization, and cost management. From the Record of the Society of Actuaries, Vol. 25, No. 3.

Description: Panelist discuss issues relating to new medical technologies and how these are going to affect the practice of medicine, the delivery of care, the costs of care, the insuring of care, claims handling, utilization, and cost management. From the Record of the Society of Actuaries, Vol. 25, No. 2.

Description: Presented at October 1986 Annual Meeting. This session discussion is about the state-of-the-art in packaged software, the requirements of such systems, and current and future health care developments that must be addressed.