Description: How do we take a Minimum Viable Products (MVP) approach to launch new insurance products? Join this moderated discussion and focus on three key development aspects: Distribution, Systems, and the design and pricing of the Insurance product itself. Come discuss reasons to choose an MVP approach and how it solves many of the product launch challenges.

Description: Welcome to the future of insurance, for actuaries and non-actuaries! Discover how cutting-edge AI models are revolutionizing underwriting, risk assessment, and customer experience for the insurance industry. Experts in management consulting and actuarial consulting firms will provide valuable insights into the consideration and challenges surrounding the adoption of Generative AI.

Description: 2021 Life Meeting - Session 5F: Premium Leakage - How Outdated Claims Systems are Losing You Money 8.31.21 Recording

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: Risk adjustment in government regulated health plans has been around for over two decades. Yet the strategies for promoting risk score accuracy haven't varied much during that time. Most health plans, physician groups, and vendors promote chart reviews and/or in-home assessments as the primary vehicle for collecting data not perceived to be present in the routine claims submission and adjudication stream. We know that most organizations trying to coalesce encounter data from multiple sources often fail to ensure that all relevant data is ultimately submitted to CMS or a state Medicaid agency. Crucial data, often with significant financial value, frequently gets lost in the data pipeline, somewhere between the provider's billing system and the health plan and/or its vendors. Because 837-formatted data is difficult to read, it complicates payers and vendor’s abilities to track encounter data so that every service delivered to patients is credited to the applicable risk adjustment formula. It is incumbent upon successful risk-adjusted entities to be able to track encounter data, identify processes and/or vendors which may be mangling or losing data, in order to ensure that risk scores are sufficiently accurate to be compliant with plan sponsor requirements and to ensure appropriate revenue to the health plan or provider group.

Description: Learn how modernization of data, models, and technology are influencing workflows. This webcast will address how workflows are changing in response to new regulatory requirements and the impacts the changes have on modeling and end-to-end future state operating models. Industry leading actuaries will discuss: How team collaboration can increase quality and speed of reporting to internal and external stakeholders How to strengthen controls and compliance frameworks across finance and actuarial departments How to modernize actuarial input/output for strategic analysis and insights How to attract and retain top talent by improving opportunities for actuaries There will also be dedicated time to ask questions of those who have made the transition.

Description: Data visualization is a hot topic within the industry. This session will showcase business use cases of data visualization models to build, for example, a claims trend story from outlier analysis to root cause in real time. There are many different ways to assemble pie, bar, or other types of charts, but critically understanding the business questions and following visualization best practices can accelerate the pace of identification to actionable result. Additionally, moving up the analysis continuum from busy Excel files with thousands of numbers to automated Tableau dashboards highlighting only the most impactful numbers with full drill-in capabilities improves both efficiency and communication to non-technical audiences.

Description: Is your development team or IT staff growing tired of last-minute requests to include additional functionality? Have you strained to explain challenging actuarial topics to non-actuarial staff for implementation? Do your teams find themselves revisiting deadlines & timelines when building solutions? During this interactive panel discussion, three technologists (two software engineering managers and one data scientist) along with three actuaries will discuss real world problems and approaches using experience from previous projects. Although the challenge of running efficient software teams is not unique to actuarial science, this webcast will discuss best practices on how to organize teams to reduce friction and context switching. Presenters will also explore unique actuarial challenges and concepts including how to address standards on data quality when building software, how to build intuitive software that meets actuarial standards and how test-driven development makes it easier to meet actuarial standards of practice.

Description: The famous 80/20 rule in data science states that only 20% of your time working with data is spent driving insightful business analytics. The rest of your time is spent trying to query, clean and organize your data. Even with this knowledge, the majority of actuarial training/focus is on the 20 percent. This session takes a different approach, focusing solely on speeding up your work on the other 80 percent. Practical examples will be part of a code walkthrough in R.

Description: Digital savvy consumers are demanding a change in the way they engage with their insurance carriers. As smartphone owners utilize their devices for financial management more than ever, insurance carriers aim to create a similar seamless digital strategy, offering customers a personalized experience on multiple platforms. Cloud-based applications also enable productivity, accountability and innovation in the insurance industry. Discover avenues of customer engagement through digital platforms, including new technologies and products, and why the value of data and data science is critical for business, such as adaptability, marketing and insightful pricing. Presenters will also touch on: - managing retention and lapses through data-driven continuous improvement cycling - high-level system architectures illustrating how multiple applications (front/mid/back office systems) will integrate with each other and share connected data example data points being captured within various marketing systems - data collection within various digital platforms - data science applications that help with business growth, retention, lapsation, effectiveness and cross-sell/up-sell opportunities, and the implications to actuarial functions - value and risk to carriers in the new digital paradigm