Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.

Description: This report provides a validated, structured dataset of demographic and socioeconomic variables to support mortality heterogeneity research across geographies and population groups.

Description: CMS has required hospitals to publish their chargemaster rates, cash discounts and negotiated rates as of January 1, 2021. Our panel is comprised of a data strategist, an executive from a large hospital system and an actuary.

Description: This session will examine bias from a social science perspective. It will discuss the three types of systemic biases using the National Institute of Standards and Technology (NIST) model. The NIST model details the three types as historical bias, societal bias, and institutionalbias. The session will also provide several examples of each type to provide a framework for identifying the social structure of bias.

Description: Risk Adjustment continues to be a hot topic in Health Insurance since its emergence. This mechanism came into being as a means of reducing the risk of selection, particularly in marketplaces where underwriting is not allowed, and rating factors are significantly restricted. Risk adjustment serves to adjust premiums to reflect the risk of individual members or overall members as a whole within a particular cohort of a health plan. Risk adjustment is not perfect, as it does not perfectly predict future costs or perfectly adjust for the differences in expected costs. Different marketplaces have different challenges with risk adjustment.

Description: On September 14, 2022, The Wall Street Journal hosted its ‘Future of Health’ event, which was a virtual event featuring three sessions on some emerging cutting-edge topics that could impact the future healthcare environment as well as health care actuaries. This report summarizes the event.

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: This study of socioeconomic inequalities in mortality builds on a previous report in which we identified a large and growing gradient in life expectancy between 1982 and 2019 across U.S. counties classified into 10 socioeconomically homogeneous categories. In this report, we seek to identify the particular causes of death contributing to the growing disadvantage in mortality between populations in the least and most affluent deciles as previously defined.

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: 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.