Description: Every patient leaving the hospital has personal life-context circumstances that impact their chances of successful recovery and complications can be costly. Complex care management impacts over 50 percent of health care spend, with the admitted commercial population driving 37 percent of spend or $177M per 100,000 lives and the Medicare population driving 53 percent of spend or $600 million per 100,000 lives. The stakes are high, but existing care management solutions are mostly clinical and navigation call centers provide fragmented and outdated patient management systems, and do not address individual life-context. Discharged patients therefore remain underengaged and undercompliant, leading to costly complications. Innovative technology can help enable and integrate systems and existing infrastructure to leverage evidence-based contextualized care that will enhance care management, improve efficiency, and drive a better experience and outcomes for patients. This technology helps codifies life context, dynamically stratifying and engaging members digitally and telephonically helping virtual care teams to be more effective and efficient. In a recent randomized clinical trial, this technology and approach has shown a 50 percent reduction in the total cost of care, cutting the average and total cost of readmission, increasing virtual care team impact and member engagement and trust.

Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

Description: The article explores how integrating AI into insurer apps can address critical challenges in healthcare, such as patient no-shows, medication adherence, and cost management. These non-disruptive approaches aim to increase the effectiveness of patient interventions and improve medication adherence.

Description: As the insurance industry continues to evolve due to a pandemic and rapidly changing economic and regulatory conditions, the role of data scientists and actuaries has become increasingly important. In an interview with the Atidot data science and actuarial team, we discuss what it is like to work at an InsurTech, how data scientists and actuaries can collaborate, and look at some concrete technical examples of where the innovation is having an impact. This article explores what collaboration can look like and how the role of data science and actuary may evolve in the InsurTech industry in the future.

Description: The Society of Actuaries (SOA) Board of Directors (Board) gathered in Chicago March 16–17 for its first meeting of the year. Among key topics on the agenda were the FSA pathway evolution update, Board elections, strategic planning and the use of AI in the workforce.

Description: This article is a brief overview of what digital health is, how it is regulated, and who some of the big unicorns are.

Description: During the2019 InsureTech Connect conference in Las Vegas, the Society of Actuaries (SOA) and Plug and Play today announced the two organizations are nearing an agreement on professional development offerings and learning opportunities. The SOA and Plug and Play plan to work together on a variety of InsurTech-focused events and projects for the SOA membership, insurance industry and technology sector.

Description: This article describes one of the keys to successful marketing in the current environment - build a relational database that will help the agent communicate with a client in an organized way, so that we can educate, inform, present choices and help these clients navigate their financial future. This article provides the elements of such a database.

Description: An overview of the basic tooling and packages available for the Julia programming language, with a focus on why this is of interest to the actuarial profession. It covers some of the built-in language features as well parts of the Julia package ecosystem that make Julia ideal for modeling and data analysis. This is the second installment in a series of article aimed at actuaries. The first installment, Julia for Actuaries, was published in the October 2020 edition of Actuarial Technology Today, and covered the base language itself, its high-level, math-friendly syntax, and why the actuary of the future should consider its adoption.

Description: This is the first of two articles discussing technologies used to control data. this article covers data management strategies.