Description: 2021 ImpACT Conference - Session 12E: AITSC Present II – Actuarial Innovation and Technology Research Roundtable 10.29.21 Recording

Description: 2021 ImpACT Conference - Session 7A: Conversion is 'Done'. What Happens Next? 10.27.21 Recording

Description: 2021 Life Meeting - Session 5F: Premium Leakage - How Outdated Claims Systems are Losing You Money 8.31.21 Recording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: Innovation in technology is being leveraged throughout the entire customer journey. The presenters will focus on solutions that affect both the client experience, the productivity of the agent and the efficiency of the life company. Some InsurTech companies that have developed solutions across the value chain - beginning with front-end solutions to improve the productivity and expertise of agents. These include cloud-based product illustration, advanced sales concept systems, financial calculators, e-applications and e-signature technology. Solutions that improve the efficiency of policy underwriting and issue include automated underwriting systems, expert requirement systems and underwriter workbenches. Finally, solutions that automate inforce policy management and compliance include anti-money laundering AI systems, in-force illustration systems to satisfy annual statement compliance and claims processing systems. There is a race to gain competitive advantage by getting to a digitally transformed future first.

Description: Eager to learn more about what an InsurTech is, how they operate in the insurance ecosystem and how actuaries can participate in this ecosystem? Join actuaries, InsurTechs and participants in the ecosystem to discuss the recent research report on InsurTechs by the SOA. At the conclusion of the session, attendees will be able to: • Know more about InsurTechs and how they operate • Understand how insurers work with InsurTechs • Discover how actuaries can participate in this ecosystem • Learn practical lessons from both InsurTechs and actuaries This session is presented by the Entrepreneurial & Innovation Section.

Description: 2021 ImpACT Conference - Session 4C: Technological Barbarians at the Gate: Learning from Upheaval in Other Industries 10.26.21 Recording

Description: Ensuring employees retire with adequate benefits is an ever-growing challenge. During this webcast, we will highlight key insights from the fields of behavioral economics and data analytics that can be utilized to better equip employees for retirement. Areas of focus will include inherent biases that people exhibit and how employers can use these biases to design plan features that will nudge their employees towards making better decisions for their futures.

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.