Description: "Risk adjustment is an important aspect of establishing appropriate capitation rates. When a set of services is carved out for specific management under a sub-capitation, establishing appropriate adjustments for varying levels of underlying risk is more complicated. Dive into analytical and operational challenges and resolutions as presenters share more about developing a risk adjustment model specific to the carve-out of behavioral health services through a real-life case study. You will further explore a definition of the use case, availability of historical data sets, selection of the modeling approach, learnings from the iterative modeling process, and the potential application of the results. After attending this session, you will be able to: Understand why a behavioral health specific-risk adjustment model has business value Understand the unique challenges related to developing risk adjustment on member and cost subsegments Understand the impact of trade-offs between model complexity and interpretability in the context of implementation Increase awareness of data nuances and requirements unique to this type of project Describe analytic techniques that can be investigated for use in projects of similar business objectives"

Description: 2021 ImpACT Conference - Session 1E: Transforming Group Underwriting Using Artificial Intelligence and Machine Learning 10.25.21 Recording

Description: Discover the impact of COVID-19 on member costs post diagnosis and the future of mortality in this Emerging Long Term COVID-19 Trends webcast. This webcast will be split up into Health and Life portions. During the Health portion of this webcasts, you will learn more about the impact on risk scores due to recent findings. Enjoy this discussion and further dive into the emerging COVID-19 trends that may affect how you conduct business practices. At the Life portion, the SOA Research Institute assembled a panel of mortality experts who will express opinions on the effects of the U.S. mortality rate for general, insured and pension populations in the short-term.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.