Description: The COVID-19 pandemic initially caused some health care services to shift away from in-person transactions to a digital form, including telehealth, e-mails, remote patient monitoring and other forms of communication. If sustained, numerous effects and counter-effects both in the cost and quality of care as well as long-term outcomes for patient health may emerge.

Description: Gather with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, pension, investment, product strategy, and more.

Description: Disability and group life products can pose challenges for the valuation actuary due to the long-tail runout of traditional disability and group life waiver of premium claims, and due to the sensitivity of the reserves to small changes in assumptions. This session addresses a number of issues of interest to actuaries who work with these products, including recent experience trends and the new 2023 Group Life Waiver Valuation Table. Attendees will learn about best practices in the valuation of these products.

Description: Health equity is taking a front row focus in many health arenas. Take a closer look at some of the efforts being used to ensure health equity. One area of interest to actuaries is value-based insurance designs (VBID). VBID can be incorporated into exchange plans. These innovations to prevent and treat disease have led to reductions in morbidity and mortality. Learn techniques to improve the quality of care and reduce barriers to high-value care in the form of high-cost sharing.

Description: ACA risk adjustment has now been in play for years. The original intent of risk adjustment was to help stabilize the market through measuring risk levels of each issuer. However, the risk adjustment program may have introduced additional uncertainty due to annual market shifts and model changes, making risk adjustment estimation is a difficult task. This article analyzes the results over time, including impacts from market changes and model changes.

Description: This report explores AI bias in insurance and health data, highlighting the ethical role of actuaries and offering cross-disciplinary guidance for fairer decision-making systems.

Description: This paper is about an Interacting Particle System [IPS] approach to modeling treatment costs associated with a multiple stage pandemic. The model population receives differing treatments with possibly differing costs depending on the stage of exposure/infection. The total cost of treatment is a time varying utility function of the ensemble population for which this approach uses particle system methods to simulate the cost of maintaining survival of the population. The paper gives a brief background on particle systems with specific focus on 'the contact process', followed by expanding the contact process to represent more realistic state transitions.

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: Discussion of issues from The Credibility Task Force for Health Coverage. From Health Section News, June 1998, Issue No. 35.

Description: Considerations in the Development of Area Factors, Issue No. 38.