Description: Identifying and submitting all appropriate ICD-9 diagnosis codes to CMS will result in a higher risk score for the member and increased payments to Medicare Advantage plans. Milliman's HCC prevalence study illustrates the significant variations in HCC prevalence rates by age/gender, geography, and population type and will assist plans in benchmarking the effectiveness of their own diagnosis code capture efforts.

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: This paper examines a differential equation model, whose solutions have yield curve shapes. The paper also examines the relevance of the model with historical monthly U. S. Treasury nominal rates. From the Actuarial Research Clearing House 1992 Vol. 1 .

Description: Presents a theoretical basis for a computerized methodology for estimating biological age - a measure of time to death.

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: This chapter introduces a few probability distributions that play an important role in understanding and analyzing healthcare data. While theoretical in nature, these distributions model real life if appropriately chosen. Probability distributions are mathematical representations of how statistical data behave.

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

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: "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."