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: 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: Actuaries are leveraging predictive modeling and machine learning more and more as they strive to provide greater value to their stakeholders. Actuarial standards of practice provide guidance around modeling and data. The world has changed significantly over the last few years, so it is important these models be tested for fairness as well as any statistical biases. This article addresses some of the key issues actuaries need to be aware of as Corporations and society work through the responsible us of this technology and underlying data.

Description: Data is everywhere. Health care generates as much as 30% of the world’s data, and new technologies are changing how life insurers analyze consumer information. Actuaries are business-savvy problem solvers. They understand how to leverage the latest technologies and techniques to turn data into actionable insights and solutions for businesses and can communicate those findings to multiple audiences. SOA-credentialed actuaries use predictive analytics to inform organizational and business strategies, with efforts such as identifying chronic conditions in their early stage or determining stress levels through sweat patterns.

Description: After a decade of traditional actuarial work in health care, David Sotelo was seeking a new kind of opportunity to make an impact. He found it at Collective Health, where he works with a team of actuaries and data scientists that use analytics to streamline health insurance.

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: Career changes typically follow a major milestone—a promotion, a job offer, a new degree, maybe a cross-country move. For Patrick Getzen, exposure to some new perspectives ignited a shift.

Description: SOA predictive analytics certificate program provides strong theoretical background and practical, hands-on experience that can be applied to decision making

Description: Carol McCall led three teams – predictive analytics, health economics and outcomes research, and personalized medicine. The “river running through them” was that they all leveraged data. Her predictive analytics team eventually built a broad portfolio of models with some of them having a significant impact on Humana’s top and bottom lines.

Description: As a film major in college with a dream to shoot movies, it’s safe to say Michael had a nontraditional start to his career in predictive analytics.