Description: A look at the near future and far future of various elements of Actuarial Models as defined through ASOP 51. What is driving the complexity for inputs, calculations, and outputs. Howe will actuaries handle these challenge?

Description: This session explores the far-reaching changes to how clinical data will be sourced, processed and consumed in many payer use cases including risk adjustment, quality measurement, care management, claims adjudication, prior authorizations, and other payer functions. Robust, interoperable data exchange is a prerequisite for value-based care. Clinical data will be increasingly accessible to augment administrative (claims) data via standardized Fast Health Interoperability Resources (FHIR, pronounced 'fire'), at a fraction of the cost of a accessing a traditional medical record and in real-time. On May 1, 2020, HHS issued a final rule implementing interoperability and the patient access provisions of the 21st Century Cures Act of 2016, although enforcement has been delayed into 2021 because of the COVID-19 pandemic. The new regulations promote, “HHS’s vision and strategy for achieving a health information ecosystem within which all individuals, their personal representatives, their health care providers, and their payers are able to send, receive, find, and use electronic health information in a manner that is appropriate, secure, timely, and reliable to support the health and wellness of individuals through informed, shared decision-making, as well as to support consumer choice of payers and providers.”Once enforcement begins, CMS and the Office of the National Coordinator for Health Information Technology (ONC), have the authority to mandate adoption of interoperability requirements, and also penalize payers and providers for non-compliance or the delay and withholding of data.This ‘digital transformation’ of the clinical data ecosystem has far-reaching implications for enabling technologies including Natural Language Processing (NLP) and entire segments of services and vendors. It will eliminate many departmental barriers, duplication and error sources for health plans and impact every department and the underlying economics of delivering and managing care.

Description: This chapter focuses on creating practical models that aid in the prediction of the risk of readmission to a specific hospital within 30 days of discharge for Medicare patients, to aid in the identification and stratification of at-risk patients for hospitals considering building an intervention program in a cost-effective manner. For readers who wish to develop their own predictive model, a dataset is provided on the Actexmadriver.com website, and R code is provided in the appendix to this chapter.

Description: 1) Vision of the applications and development of data analytics in life insurance industry in Asia; 2) How big is the pie and what are the current obstacles insurers are facing; 3) Utilization of data and analytics target operating models as a competitive advantage, with focus on future readiness, controls, efficiency and effectiveness; 4) Potential roadmap ahead: a) Assessment of the current state of maturity levels of data and analytics initiatives; b) Identification of technology and competency gaps; c) Establishment of data integration and management process within BUs, alignment of advanced analytics tools across departments, with centralized data governance, technology structure and decision making framework; d) Definition of criteria and metrics to measure key outcomes and business value added. 5) Case study on agency behavior management: a practical example on how data analytics is being used in practice: (a) key business objectives: improve agent behaviors and maximize productivity with the lowest possible compensation costs; (b) data collection and current state assessment; (c) detailed predictive modeling process, modeling outcomes, and business implications; (d) implementation and monitoring process.

Description: 1) Vision of the applications and development of data analytics in life insurance industry in Asia; 2) How big is the pie and what are the current obstacles insurers are facing; 3) Utilization of data and analytics target operating models as a competitive advantage, with focus on future readiness, controls, efficiency and effectiveness; 4) Potential roadmap ahead: a) Assessment of the current state of maturity levels of data and analytics initiatives; b) Identification of technology and competency gaps; c) Establishment of data integration and management process within BUs, alignment of advanced analytics tools across departments, with centralized data governance, technology structure and decision making framework; d) Definition of criteria and metrics to measure key outcomes and business value added. 5) Case study on agency behavior management: a practical example on how data analytics is being used in practice: (a) key business objectives: improve agent behaviors and maximize productivity with the lowest possible compensation costs; (b) data collection and current state assessment; (c) detailed predictive modeling process, modeling outcomes, and business implications; (d) implementation and monitoring process.

Description: The following case study walks through the steps of a predictive modeling exercise to illustrate one way analytics can streamline the underwriting paradigm.

Description: Profile of an actuary in a non-traditional actuarial role: focusing on medical cost and analysis, both retrospective and prospective.

Description: As the insurance industry continues to evolve due to a pandemic and rapidly changing economic and regulatory conditions, the role of data scientists and actuaries has become increasingly important. In an interview with the Atidot data science and actuarial team, we discuss what it is like to work at an InsurTech, how data scientists and actuaries can collaborate, and look at some concrete technical examples of where the innovation is having an impact. This article explores what collaboration can look like and how the role of data science and actuary may evolve in the InsurTech industry in the future.

Description: Panelists discuss pricing issues, patent issues, safeguards, successes, failures, and other observations about the future of automated underwriting. From the 2002 Record of Society of Actuaries, Volume 28, No. 3. Session 134PD of the Boston Annual Meeting.

Description: Data is an essential component of financial analysis. In this session, the presenters will discuss data governance/management framework and how it can be applied to US GAAP LDTI and VM-51 regulations. This session will also discuss the important relationship between actuaries and IT and how they can work together towards best practices for extracting, managing and using data needed for various actuarial models. Real life case studies relevant for valuation actuaries (e.g. data needs for LDTI and VM-51) will also be presented and examined, highlighting best practices as well as challenges and pitfalls for setting up and governing data processes along with areas for where good communication and strong relationships are important to success.