Description: There is a lot of focus on GTI and its impact on modeling, methodology and transition. However, given the dependencies that exist on the data infrastructure, the implementation of the guidelines is an ideal opportunity to also streamline and improve data storage, data transformation, and reporting processes to create an efficient, effective and scalable data solution. This session will focus on the specific impacts and possible solutions to the following data processes: In force data Experience studies and assumption setting post model data feeds and subledger processes Data warehouse and reporting systems

Description: Everyone loves efficiency. But what does it truly mean for something to be efficient? An actuary who has spent almost 20 years managing process improvements shares his experiences and the evolution of his views on efficiency. This parable highlights the broader aspects of efficiency that are often missed, and some of the challenges that can come from targeting a typical view of efficiency.

Description: Medicare Advantage Organizations must consider influences both internal and external to the adjudication process as they review and use data for bid preparation

Description: While medical and pharmacy claims data is a well-established source for healthcare analytics, significant data can be found elsewhere in electronic medical records (EMRs) and in hospital admit, discharge, and transfer (ADT) messages. Increasing availability of bulk EMR data to analyze coupled with more powerful and specialized tools for analyzing it presents an opportunity for actuaries to incorporate these sources in their work. This session will take a look at some of the data available beyond claims in EMRs and HL7 ADT messages, and will discuss case studies, with consideration around structure, ease of use, cleanliness, and tools available for analyzing these data types including natural language processing.