Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.

Description: This session discussion is about claim processing technology. Its artificial intelligence, medical expert systems, optical scanning and electronic claim submission. From Record of the Society of Actuaries Vol. 15, No. 1.

Description: The presenters discuss the results from the CIA/SOA-sponsored survey on analytics practices of the Canadian life and health insurance industry. This is an opportunity to understand what other companies are doing and benchmark your practices with those of your peers and gain deeper insights about potential applications and their perceived value and effort. Attendees do not need specialized knowledge in predictive analytics to benefit from the information presented. Examples are provided from a Canadian context, but potential applications are relevant across a wide spectrum of geographies.