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: 2021 Life Meeting - Session 5C: Assumption Setting in an Uncertain World 8.31.21 Recording

Description: Actuaries are increasingly being asked to incorporate Economic Scenario Generators into their work. Whether it be a Risk Neutral model for pricing or a Real-World version for Economic Capital modelling, using these tools can help produce a much more robust analysis. Unfortunately, these models and their underpinnings are also very complicated, which can lead to confusion. The presenters in this session will try to demystify some of this. In particular, they will address the following questions: • What is the difference between Real-World and Risk Neutral scenarios? • When should I use one or the other? • How are these models calibrated? • What are some of the misconceptions about these models?

Description: Variable annuity (VA) writers are facing many challenges in today's economic environment. Equity market volatility and low interest rates make guaranteed benefits increasingly expensive to hedge. Both GAAP Long Duration Targeted Improvements and the recent VM-21 changes will drive the need to manage the VA business under a new set of lenses. During this session, the presenters will explore the various in-force management tools VA writers have available and comment on their effectiveness.

Description: Economic Scenario Generator - Investment Section Web Series Session #2 - Real World This session will cover the following points: 1. NAIC ESG 2. Strategic Asset Allocation and Optimization Techniques 3. Covid-19 Postmortem: Modeling and calibration changes because of recent events

Description: Data science, predictive analytics and AI are certainly the buzzwords these days. They are heavily used and developed in underwriting and marketing but for most actuaries, they might/may as well be science fiction. The presenters will demonstrate how a normal actuary can utilize data science techniques in their daily job function without forming an official data science team within a company. It can be done in a gradual fashion so that normal business is not disrupted and improvements are made over time. The usage of data science techniques will include demonstrations of the following areas: - Regression analysis - Economic scenario generator - Experience study - Data quality checks - Inforce compression for explicit hedging

Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge

Description: Pricing is a central activity of actuaries to assure solvency and to manage risk. Life insurance is also a social good, not just a product, and the US population is massively underinsured. Pricing must strike a balance. Unlike a simple 4x4 matrix to produce pricing, today's technology offers the ability to evaluate literally thousands of variables, enabling a kind of precision pricing. It also heightens the possibility of introducing bias and discrimination through the use of unregulated third-party data.

Description: 2021 ImpACT Conference - Session 3B: Tax Changes During COVID-19 10.26.21 Recording

Description: Economic Scenario Generator - Investment Section Web Series - Risk Neutral