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: Can we improve upon traditional methods of risk measurement and risk selection? Panelists discuss potential applications of predictive modeling, including individual underwriting, group rating and provider reimbursement. They focus on ways in which predictive modeling can be used to improve risk selection, experience rating and provider reimbursement. A session at the Health/Pension Spring Meeting held in New Orleans, Louisiana June 15-17, 2005. From the Record of the Society of Actuaries, Vol. 31, No. 2.

Description: Presented at April 1986 Spring Meeting. This session discussion is about what analysis is effective in measuring recent medical care experience and are the projected cost-containment savings presented to plan sponsors being realized.

Description: Presented at May 1985 Spring Meeting. This session discussed: What measures should be used in setting objectives and evaluating performance for companies and product lines, What variations are appropriate for stock and mutual companies and for United States and Canadian companies.

Description: Presented at April 1985 Spring Meeting. This session focused on recent experience of programs designed to contain health care costs.

Description: The proposed session will introduce Outcome Based Risk Sharing Arrangements (“OBRSA”) between health insurance payers (“payers”, including insurance companies, health plans, sponsored employers, and government programs) and pharmaceutical manufacturers (“pharma”), and it’s intended to meet the needs of actuaries who focus on pharmacy benefits and risk sharing arrangements. The covered content will include (1) the background of OBRSAs, definitions, stakeholders, and OBRSA’s role in shifting the system from volume-based toward value-based; (2) conflicting perspectives about OBRSAs between payers and pharma (cultural and methodological); (3) identification of incentive gaps between payers and pharma, and incentive alignment between them; (4) barriers to implement OBRSAs; (5) limitations and considerations of OBRSA implementation; and (5) hypothetic OBRSA examples.

Description: "Visual storytelling is frequently used to effectively convey complex actuarial concepts to our clients and other audiences. When talking about data visualization, we often focus on the explanatory aspect. But data visualization is also a crucial tool in developing insights from large and complex data sets at every stage of data analytics spectrum: • descriptive (what happened?), • diagnostic (why it happened?), • predictive (what will happen?), • and prescriptive (how do I influence what will happen?). In exploratory and modeling stages of data analytics’ project, we let the data tell the story or explore our intuition and hypothesis through data pictures. We demonstrate the power of visual display in healthcare data analytics through vivid examples from the healthcare case studies. These illustrations of data visualization exploratory power range from assessing the quality of data or examining outliers, to exploring variables’ relationships and trends, to hypothesis testing, to guiding in feature selection and models’ comparison and evaluation, to model validation. Throughout these illustrations, we will discuss principles of graphical effectiveness, excellence and integrity."

Description: Presented at October 1986 Annual Meeting. This session discussion is about profit analysis and elements of profit such as: interest, mortality, lapse experience, expenses, reinsurance, taxes. It also about use of profit analysis as a business tool to drive management action.

Description: Underwriting is one of several areas in the insurance industry being impacted by insurtech. In this session, we will hear from experienced experts in underwriting transformation. Digitization, machine learning and other approaches are among topics to be discussed.

Description: Presented at May 1985 Spring Meeting. This session discussed the differences in the reporting of product line and source of earnings results between insurers and banks and the practical problems which exist in interpreting gain by source or product-level.