Description: Any analysis of risk assessment and risk adjustment must pay special attention to large claims. If the goal of risk adjustment is to motivate carriers to be efficient,, as opposed to motivating carriers to select the best risks,then finding a solution to the problem of compensating carriers fairly for these high-cost claimants is an absolute necessity. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.ese

Description: Employer and payers need to actively seek change in the system of mental health care deliveryoperational, clinical, and financial change. From Financing Chronic Care Monograph, M-HB05-1.

Description: The presenters will explore the roles of mental health and social determinants of health in the management of a population's total health. We will explore how emerging sources of data and information have led to a renewed focus on managing mental health conditions and social determinants of health. Speakers will address current health care programs that utilize this data and information to manage the total care for populations using predictive models to improve the deployment of resources and initiatives to improve the cost of care and health of populations. The presenters will also look at how providers of care are approaching mental health co-morbidities to manage physical health and social determinants of health in the management of patients.

Description: This Society of Actuaries Research Brief has been constructed to highlight some of the key features of the COVID-19 epidemic and contemplate the risks for the actuarial profession to consider in their work.

Description: Early in his career, Ehren Nagel, FSA, MAAA, scoured through podcasts and articles about predictive analytics, long suspecting this was a field with potential for him.

Description: Vast sums of private equity are flowing into start-ups intent on lowering healthcare trend. This presents a huge challenge for insurance company actuaries to stay current on such start-ups and the innovations they're advancing. Further, it can be overwhelming to evaluate the many vendors eager to sell their services to the company. This session will provide an overview of the start-up and private equity process, review some of the emerging innovators, and discuss approaches to evaluate their Return on Investment (ROI) as efficiently as possible.

Description: CMS provides a significant and growing amount of information that can be leveraged by actuaries. Between the public use and research files CMS makes publicly available, large amounts of information that can be assimilated to help understand the who, what, when, where and how of Medicare. With the CMS allowance of supplemental benefits to address SDOH, adding SDOH data into your data landscape is critical to better understand your members' cost drivers. The presenters will focus on the depth and breadth of data available, summarize any restrictions on the use of the data, and identify areas where access to the new data can provide more meaningful insights.

Description: This Society of Actuaries Research Brief has been constructed to highlight some of the key features of the pandemic and contemplate the risks for the actuarial profession to consider in their work.

Description: This paper reviews the geriatric literature to identify risk factors that could be used by insurers to identify existing or incipient frailty.

Description: Chapter 7 reviews several items that the study identified as requirements for a good risk assessment method. They are: accurate predictability, practicality and reasonable cost, limitation on ability to game the system, timeliness in regard to premiums, appropriate incentives for efficiency. From A Comparative Analysis of Methods of Health Risk Assessment, M-HB96-1.