Description: This model arose from a project to evaluate the cost of a health care access' program to provide comprehensive medical care to uninsureds in Minnesota, for the Minnesota Health Care Access Commission. The project was to provide estimates of the impact on per-person and aggregate costs for various participation percentages in the access program. In order to evaluate those costs, the antiselection model described in this was developed. Of note, this was the ACTUARIAL EDUCATION AND RESEARCH FUND 1991 PRACTITIONERS AWARD WINNER. From Actuarial Research Clearing House 1991, VOL. 2.

Description: The U.S. health care industry has gone through a dramatic change during the past several years. The business model has moved from a risk selection model to a risk management model. People can shop online for their health care coverage. Everyone is welcome! Annual and lifetime dollar limits, underwriting and the pre-existing conditions exclusion are all in the history book now. Facing the challenges of the post-reform era, many health insurance carriers began using big data analytics on all aspects of their decision-making processes. The goal is to be able to compete on analytics in this quickly changing environment. However, becoming an analytics competitor is not easy. It requires the belief from the leadership and a group of dedicated analytical professionals to solve emergent business problems that existing strategies cannot address in an evolving market. These problems include marketing for acquisition and retention, coding accuracy, revenue growth, health care disparity, payment integrity, quality of care, health care cost reduction and, ultimately, personalized care management. In this section, audience will learn a basic understanding of the role of predictive analytics in US Healthcare marketplace.

Description: This article discusses the advantages, logistical concerns, and pricing formulas of implementing a TNHP, in which members pay less for treatment from providers who meet higher quality and cost-effectiveness standards.

Description: According to the Actuarial Standards Board’s Actuarial Standard of Practice No. 49 (ASOP 49), actuarially sound Medicaid managed care capitation rates will include a provision for underwriting gain in order to provide compensation for the risks assumed by an MCO. However, there is no generally accepted method for quantifying underwriting gain in managed Medicaid capitation rates. This article discusses a new model developed to address this void and calculate underwriting gain. The model was developed by researching existing financial literature and performing a statistical analysis of industry data to build out a framework that can be leveraged to estimate underwriting gain.

Description: This session is a primer on how to apply Gestalt psychology to display quantitative information to improve neural receptiveness. While much of brain functioning is still a mystery to psychologists and neuroscientists, we do understand a great deal about which parts of the brain engage or disengage given visual cues. Actuaries are often tasked with presenting very technical information and are prone to focus more on the substance of numerical data rather than a pictorial presentation based on neural preferences. This presentation will discuss how to display quantitative information more effectively tailored to these preferences.

Description: Read the November 2019 issue of The Modeling Platform, published by the Modeling Section. Newsletters provide practical information for the working actuary, articles on trends that impact sections and news about section activities.

Description: This article is the first installment of a three-part series that aims to provide an overview of ESGs and will focus on the general motivation for stochastic modeling, its advantages and its limitations. Future articles will further break down the key factors of ESGs and the application of these factors to better understand the Academy Interest Rate Generator (AIRG).

Description: This paper reviews the general methodology of capture-recapture procedures and describes some applications such as estimating the size of the undercount in censuses and estimating the number of duplicate records on in a database. From Actuarial Research Clearing House 2006.

Description: This paper presents a method that uses three-dimensional graphs to solve stationary population problems. From Transactions of Society of Actuaries 1981, Vol. 33.

Description: 2003 Valuation Actuary Symposium, San Diego, CA. In this Teaching Session the instructor discussed the importance of making sure the correct inferences were drawn from stochastic testing exercises. Topics included: 1. Applying the assumption of a normal distribution. 2. Drawing inferences about, and creating confidence intervals around, a population mean. 3. Drawing inferences about, and creating confidence intervals around, tail percentiles. 4. Certifying anticipated mortality under XXX in a mathematically concise way.