Description: This paper reviews the geriatric literature to identify risk factors that could be used by insurers to identify existing or incipient frailty.

Description: This is a sequel to Panjer's paper. The Walter Reeed Staging Method - WRSM - is a method that groups patients infected with HIV into various stages. This paper looks at mathematically modeling the transition process of HIV by using the WRSM. This paper argues that Panjer's results are biased and understates the average time it will take an HIV life to develop AIDS.

Description: This document provides an explanation of the Health Company Pandemic Modeling tool excel workbook and gives step by step instructions for companies to enter specific scenarios and assumptions.

Description: The CMS Risk adjustment model allows actuaries to apply our analytical skills and business knowledge to solve risk and revenue challenges within Health Plans.

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: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

Description: Presented at Living to 100 Symposium, January 2011. This article estimates the impact of obesity and diabetes on disability and mortality for those older than 65 using the 2004 National Long Term Care Survey with disability based on the Health Insurance Accountability and Portability Act's Activities of Daily Living and Cognitive Impairment triggers.

Description: Presented at the Living to 100 Symposium, January 2011. This paper examines the relationship between the earliest stages of dementia—mild cognitive impairment—and mortality. Using data from long-term care insurance applicants, and linking this to the Social Security Master Death File, the authors focus on the classification results of two cognitive screens used at various times in the underwriting process. Applying the Cox Proportional Hazards Model as well as relative mortality ratio analysis, the authors show that the proportion of individuals classified as cognitively impaired have significantly higher relative mortality compared to those classified as cognitively intact.

Description: Discusses types and methods of analysis of morbidity experience, reserves, and policy form drafting issues.

Description: This session discusses the benefits of actuarial involvement in understand. Topics include current methods [such as teleunderwriting, use of pharmacy data] and the benefit versus cost of using various underwriting tools. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 22