Description: An approach to quantify medical intervention savings when medical claims data is not available by leveraging overlapping measurement techniques.

Description: Regression to the mean is a phenomenon that arises when comparing sequential data points. It states that when an initial observation is extreme or an outlier, future observations will be closer to the average. Health care actuaries need to understand and be able to mitigate the effects of regression to the mean to avoid misapplying predictive models or misstating measurements of historical effects.

Description: Traditional risk scoring models include only fixed (non-random) demographic and condition-based variables. By including the provider effect as part of the risk scoring model as a random effect, we can get better estimates of provider performance (incorporating practice patterns conditional on patient morbidity profile). This approach can be generalized to study other factors that are now masked in error variance (i.e. area, Social Determinants) but if modeled could give us better estimates of risk

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

Description: When setting reserves, multiple methods are often used in the creation of the reserve estimate. Judgment is warranted to combine these different estimates into a final recommendation. This paper describes two techniques that can be used to combine these estimates that may result in better accuracy and lower variance.

Description: This article provides a brief overview of the current state of machine learning (ML) and artificial intelligence (AI) as they apply to actuarial science, including discussion around the integration of actuarial judgment with ML and AI. It concludes with an example of explainable ML through a python tool known as SHAP (SHapley Additive exPlanations), which is able to explain the key drivers behind individual ML or AI predictions.