Description: Overview of evolving industry trends and examples of how life insurers in Canada are innovating.

Description: The presenters discuss the results from the CIA/SOA-sponsored survey on analytics practices of the Canadian life and health insurance industry. This is an opportunity to understand what other companies are doing and benchmark your practices with those of your peers and gain deeper insights about potential applications and their perceived value and effort. Attendees do not need specialized knowledge in predictive analytics to benefit from the information presented. Examples are provided from a Canadian context, but potential applications are relevant across a wide spectrum of geographies.

Description: A discussion of fraud and abuse in the Medicare payment system, and steps to address these problems.

Description: A discussion of insurance claims processing and payment systems, and how to achieve the minimum possible number of errors.

Description: Yi-Ling Lin, FSA, MAAA, FCA, started the SOA’s Predictive Analytics Certificate Program to keep pace with the impact big data and predictive modeling is having on the health care industry

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: Essay stating Americans need to invent, implement, and evaluate sustainable health care policies, divert cash-flow streams away from projects which feed the beast and focus on projects and policies which enhance value. It will require a combination of thoughtful, coordinated policies and a change in our cultural expectations of infinite resources and unlimited choice.

Description: In the evolving realm of healthcare actuarial practice, value-based contracts are reshaping the landscape. This article explores the pivotal role of AI-enhanced Electronic Medical Records (EMRs) in empowering actuaries to navigate this dynamic sector. Despite challenges in data standardization, AI-enhanced EMRs offer a solution by extracting and standardizing diverse medical records. The article delineates how AI-EMR integration benefits actuaries and provider organizations, enabling more accurate forecasting, earlier shared savings prepayments, and real-time quality metric aggregation. Moreover, it discusses how this fusion addresses historical data limitations, can help project catastrophic claims, and can help identify risk score capture opportunities. Ultimately, it indicates the transformative potential of AI-EMR synergy, positioning actuaries at the forefront of healthcare analytics with unprecedented precision and insight.

Description: NewsDirect article that discusses the benefits of automating the underwriting process. Underwriting speed, the east of case submission and sales support stand out as the most important factors.