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 article introduces SymPy, a computer algebra system (CAS) for the Python programming language.

Description: Many executives are talking about predictive analytics uses in health insurance.

Description: This paper is a proof of a conjecture that appeared in a letter to the Editor of The Actuary. From the Actuarial Research Clearing House 1991 Vol.

Description: A new health insurance pricing model takes external market prices into account, as well as regulatory rate restrictions and other traditional pricing factors. Rather than being assumed at the outset, lapse rates emerge from the model, along with assessment spiral & loss ratio projections. Under the model optimal pricing strategy depends on whether the class being rated has a healthier than average mix of risks.

Description: Although rate structures where low-cost cohorts subsidize high cost cohorts may be justified from a actuarial, marketing, or legal standpoint, the subsidization creates risks which must be understood and monitored. This article presents the concept of subsidization signature to measure and interpret the effects of rate subsidization, and to assess the sustainability of rating structures and the sensitivity of business mix assumptions.

Description: Up until recent past, the artificial intelligence portion of data science was looked upon cautiously due to its history of booms and flops . In the latest stream of events, major improvements have taken place in this field and now deep learning, the new leading front for Artificial Intelligence, presents a promising prospect for overcoming problems of big data.

Description: This article goes through some basic data exploration techniques to show how different approaches look.