Description: Health care predictive analytics varies between payers and providers as well as being a powerful tool in business decision modeling.

Description: Abstracts of recent articles of interest to health actuaries

Description: Even the best algorithms are only effective if they are trained on appropriate data. This article discusses common pitfalls in creating a training data set.

Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: The article is Part 1 of two articles that provide a case study for the development of a profitability and risk dashboard. The sample dashboard provides distilled information regarding actual to expected (A/E) ratios for key risks, agent quality scores and customer value scores. The dashboard would also provide the value of new business written, surplus strain, debit balances, and expected losses on debit balances at different levels, down to the agent level. A product mix index is provided, together with visual comparisons of key metrics to the company's business plan. The Part 2 article will add information to the dashboard regarding risk margins, target capital, and company value.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: The article explores the possibility of using the emerging technology for life insurers to build a monitor system for better risk and profitability management.

Description: First article in a series that walks through the progression from developing LTC assumptions using traditional methods to doing so using predictive analytics.