Description: The Society of Actuaries SoA developed this research project to repeat and expand upon its “Group Medical Insurance Large Claims Database Collection and Analysis” study, which was published as a monograph in August of 1997. The general purpose of these studies is to discover and analyze factors affecting claim incidence rates and the distribution of claim sizes. This is the report for the database. Please see the SOA website experience studies for Group Health for the databases themselves.

Description: The Individual Disability Experience Committee (IDEC) of the SOA has gathered industry data covering 2006-2015. This sessions will highlights their findings on the recent industry experience compared to the 2013 Individual Disability Income Valuation Table (2013 IDIVT), including the impact of the recession on incidence and terminations. The audience will gain an understanding of how the recent industry experience compares to the most recent valuation table. The session will cover claim incidence and claim termination Actual to Expected (A/E) using 2013 IDIVT as the expected basis. The adequacy of the modifiers will also be also be discussed.

Description: Data requirements for the Society of Actuaries cancer experience study, for those submitting exposure and claim information.

Description: This webcast will walk through several statistical methods for imputing race and ethnicity from U.S. datasets, highlighting their strengths and weaknesses, talking about how to use them and evaluating their accuracy, and telling you where you can get code packages as well as a free dataset to try the methods out.

Description: This report is a study. It discusses the objectives, scope, methodology, and limitations of the study, focusing on how diagnosis affects disability income claim recovery and mortality rates.

Description: Guidance and a model for actuaries to use when performing their professional services related to Medicaid (Title XIX) and Children’s Health Insurance Program (CHIP or Title XXI) managed care capitation rate setting.

Description: The Society of Actuaries (SOA) is pleased to present historical U.S. population mortality rates by gender and single year of age for calendar years 2000-2020. To develop these rates, the SOA relied upon data furnished by the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, the U.S. Census Bureau, and the Social Security Administration. A document summarizing key observations and the process used to develop the rates, along with a table of the rates themselves, can be found below.

Description: Every patient leaving the hospital has personal life-context circumstances that impact their chances of successful recovery and complications can be costly. Complex care management impacts over 50 percent of health care spend, with the admitted commercial population driving 37 percent of spend or $177M per 100,000 lives and the Medicare population driving 53 percent of spend or $600 million per 100,000 lives. The stakes are high, but existing care management solutions are mostly clinical and navigation call centers provide fragmented and outdated patient management systems, and do not address individual life-context. Discharged patients therefore remain underengaged and undercompliant, leading to costly complications. Innovative technology can help enable and integrate systems and existing infrastructure to leverage evidence-based contextualized care that will enhance care management, improve efficiency, and drive a better experience and outcomes for patients. This technology helps codifies life context, dynamically stratifying and engaging members digitally and telephonically helping virtual care teams to be more effective and efficient. In a recent randomized clinical trial, this technology and approach has shown a 50 percent reduction in the total cost of care, cutting the average and total cost of readmission, increasing virtual care team impact and member engagement and trust.

Description: This report covers the latest emerging trends in U.S. population mortality. The SOA relied upon data furnished by the Centers for Disease Control and Prevention (CDC). Observations are based on the CDC’s recent release of 2020 mortality experience, along with prior mortality experience data from 1999 through 2019.

Description: Anti-obesity medications have been met with reluctance from payers and employee benefits consultants who often lack analogs or empirical data to estimate the cost impact of new therapies coverage. Health plans considering coverage of anti-obesity medications will need to assess and manage the potential costs of covering these new therapies in context of their overall obesity management strategy, including coverage of nutrition counseling, weight management, and bariatric surgery.