Description: Modern actuarial work, being quite data intensive, provides many opportunities for actuaries to use the statistical skills that are part of their basic training. Furthermore, modern computing allows us to analyze vast quantities of data intensively, and each package will provide statistical 'answers' to any questions the actuary might ask of it.

Description: Renal disease is a very heterogenous medical condition whose end state is dialysis, a recurring cost intensive medical condition. Dialysis cost is one of the major medical cost drivers in USA. Insufficient and improper care management in the early stages of CKD (chronic kidney disease) leads to early incidence of end stage renal disease (ESRD) among CKD patients which not only leads to high medical costs, but also reflects poor health quality.

Description: Hear about some applications using quantile regression-derived individual and group claim distributions and how they may be used in various traditional health care modeling situations. The session will not focus on the technical use of quantile regression to obtain estimates of claim distributions, but more so is intended to focus on the uses of the distributions in actuarial modeling and the additive framework in assessing claims distributions. Presenters will show how actuaries can better assess risks by focusing on the individual- and group-specific claims distributions as opposed to traditional point-estimate-centric models.

Description: Session 3A: State-Specific Enrollment Modeling - Understanding Disenrollment Trends and Population Dynamics

Description: Almost half of recent FDA approvals have been for orphan drugs. This trend is expected to continue in 2023. Orphan drugs are priced more than 30 times higher than non-orphan drugs, therefore their cost burden in aggregate has the potential to overwhelm the budgets of payers, especially that of smaller health plans. Hear how the cost impact analysis for smaller health plans require different considerations than for a larger health plan when modeling the impact of rare diseases.

Description: Modern Actuarial work, being quite data intensive, provides many opportunities for actuaries to use the statistical skills that are part of their basic training. Furthermore, modern computing allows us to analyze vast quantities of data intensively, and each package will provide statistical 'answers' to any questions the actuary might ask of it. However, in this particular field, it is often worth taking a step back, and ensuring that we recall and consider the warnings that come with each of the statistical procedures we might attempt to use. This will allow us to ensure that we guard ourselves against drawing inappropriate conclusions, which could come back to haunt us later.At the conclusion of the session, attendees will be able to avoid drawing inappropriate statistical conclusions, while doing their work. They will leave informed about the types of pitfalls that exist, and where those might come into play in actuarial work.

Description: Artificial intelligence (AI) models have become increasingly popular in various industries, including finance. Such models can help lenders assess the risk of loan applicants, identify potential defaults and make better decisions about granting credit. However, the complexity of many machine-learning and, particularly, deep-learning models makes it difficult to understand how they arrive at their decisions. This lack of interpretability can be a significant problem in the legal and ethical realms, as it hinders transparency and accountability. Join us to learn interpretability techniques that are essential to address the challenges of using complex AI models in credit risk modeling. These techniques aim to provide a better understanding of how an AI model arrived at a particular decision or prediction. Techniques include surrogate models, which aim to provide a simpler model that approximates the behavior of the original model, and decision trees, which show the decision-making process in a more transparent way. However, applying interpretability techniques to AI models can be a challenging task. For example, some techniques can reduce the performance of the model, which can be unacceptable in applications where high accuracy is critical. Additionally, some techniques may only be effective for certain types of models or datasets, which limits their applicability. Despite these challenges, interpretability techniques are becoming increasingly important in the field of credit risk modeling. Financial regulators have recognized the importance of interpretability, and are starting to require financial institutions to use models that can be explained and validated. In addition, interpretability techniques can be used to improve the performance of credit risk models. By understanding how a model makes decisions, it is possible to identify areas where the model can be improved or where additional data may be needed.

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.