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 is an abstract for the paper, Analysis of Costs for a Chronic Disease with Acute High Cost Episodes by Marjorie Rosenberg and Philip Farrell.

Description: The article describes the insurance industry's preparation for pandemic events and the public finance response.

Description: Presented at Living to 100 Symposium, January 2011. This paper first explores the current state and contributing causes of obesity. It then explores the mortality and health care costs of obesity. It ends with a discussion of its management.

Description: The advent of machine learning algorithms has taken predictive analytics and risk scoring to a new level. From gradient boosting machines to k-nearest neighbors regression, the use of these techniques has gained significant traction in healthcare - including health systems like the Cleveland Clinic. This session will discuss the use of predictive analytics to go beyond just assessing the risk of a patient, and instead focus on prescribing a specific intervention of care. In practice, the recommendation of a care plan goes beyond just attributing a score to a patient. It provides physicians and care coordinators the most probabilistic options - e.g. referral to social worker, depression screening, weight-loss program - for positively impacting a patient's future healthcare outcome.

Description: Presented at Living to 100 Symposium, January 2011. This article estimates the impact of obesity and diabetes on disability and mortality for those older than 65 using the 2004 National Long Term Care Survey with disability based on the Health Insurance Accountability and Portability Act's Activities of Daily Living and Cognitive Impairment triggers.

Description: This session is about health risk adjusters and includes a discussion on risk assessment, actuarial applications, New York small-group reform, medical management applications, Rand 36, and other methods. From Record of Society of Actuaries Vol. 19, No. 4B.

Description: Presented at Living to 100 symposium January 2002. This paper evaluates age and sex specific patterns of change in underlying and multiple cause of death reports for the period 1980-1998 for 14 leading causes of death at ages 65 and older. Changes in four types of mortality measures will be analyzed: 1 underlying cause death rates 2 multiple cause death rates 3 associated cause death rates and 4 death rates based on the joint occurrences of multiple cause conditions. Implications of the results are discussed in the context of existing models for analyzing and forecasting future mortality patterns in the U.S.

Description: Highlights of two 2018 health events organized by the Colombian Association of Actuaries and sponsored by the Colombian Government. Seminar on Risk Adjustment and Predictive Modeling in Health. Seminar on Risk Management for the Health Insurers

Description: This session discusses the benefits of actuarial involvement in understand. Topics include current methods [such as teleunderwriting, use of pharmacy data] and the benefit versus cost of using various underwriting tools. From the Record of the Society of Actuaries, Volume 29, No. 2, Session 22