Description: Healthcare risk adjustment methodologies have become increasingly complex, largely due to the belief that complexity enhances accuracy. However, a disconnect exists between how healthcare risk is assessed and how payments are adjusted. This article explores the stark difference between measuring the accuracy of a risk assessment model at a member level, and that of a risk adjustment mechanism at the health plan level. I show that a highly simplified approach that does not use diagnosis codes can have similar accuracy on risk adjusted payments to models that do. These findings suggest that accuracy is not a barrier to developing simpler risk adjustment methodologies, which can improve payment accuracy and reduce the financial incentive for coding diagnoses.

Description: An overview of bias and fairness in machine learning models, as they apply to use cases in life insurance.

Description: This article is aimed to cover the following: 1) Provides an assessment of income volatility under Long Duration Targeted Improvements (LDTI) for several key types of long duration contracts along with select illustrations, and compares against those under current GAAP, 2) Discuss areas where accounting policies or methodologies can influence income volatility, and 3) Show how a company's management reporting can be adapted to help explain income variances under LDTI.

Description: Actuaries pride themselves on innovation and advancements; but no professional field has pushed to set the bar higher than medical Radiology. Over the course of the last few decades, medicine has begun to rely more on artificial intelligence to aid in the process of patient care; and the results have been outstanding! This article looks to show how high the bar has been set, how it will impact the current state of the world of the actuary and the future impacts

Description: Update on IFRS 17 including news, how IFRS 17 is impacting companies financials, comparisons to LDTI, and KPIs.

Description: A paper demonstrating how to obviate the need for market timing strategies in variable annuity products by judicious use of product design. The paper presents the premise behind the product design, provides numerical examples, then explores possible extensions of the concept to produce more sophisticated variable annuity plans based on guarantees of investment outcomes.

Description: The importance and opportunity, globally, of inclusive insurance is identified. We review traditional actuarial approaches, recognize their underlying presumptions, and then manage the issues raised. We clarify the process distinctions between traditional and inclusive insurance.

Description: Article reviews the data a year into the unwinding of continuous coverage provisions in Medicaid, the impact on enrollment counts, how capitation rates have been adjusted, and compares those results to what has been modeled with the SOA Mediciad Unwinding model.