Description: Sarah Rockhill, MPH, Geospatial Epidemiologist at CDC will discuss the latest in the Public Health 3.0 model in which leaders serve as Chief Health Strategists, partnering across multiple sectors and leveraging data and resources to address social, environmental, and economic conditions that affect health and health equity.

Description: How well can we predict ACA HHS Risk Adjustment Data Validation (HRADV) results? Put another way, how susceptible is the current HRADV process to small sample volatility? What potential remedies are there to the current model's shortcomings? Every plan, regardless of how many members they have above the 1000 minimum, count equally if they qualify for an HRADV with how the result is interpreted, and the subsequent HRADV risk transfer ($330M in 2023).

Description: Cover a variety of topics centered around the unsupervised learning technique called 'clustering'. The presenters will take you through a wide array of topics that range from 'What is Clustering?' to 'How can I use this technique to solve problems I didn't even know existed?' In the health care industry, everyone is looking for an edge in reducing total spend-cluster analysis finds the unambiguous in an ambiguous framework of results.

Description: Over the last 10 years, Artificial Intelligence (AI) healthcare foundation models have made tremendous strides when it comes to delivering highly accurate predictive results when compared to traditional models. This is especially true for models developed and trained on the ‘language’ of healthcare. When trained on healthcare data sequences (claims, EHR, CPT, ICD, pharmacy, lab, etc.), these models deliver far more accurate results as to WHAT beneficiary-level health events will occur and even WHEN they will occur.

Description: Reunite with members and non-members in the China actuarial community to discuss recent topics and related issues in areas such as macroeconomic sharing, IFRS 17, product strategy, cross-border communication and discussion, and more. Advance your career through learning and networking opportunities, and share your experiences in the finance and insurance industries, as well as other fields related to actuarial science.

Description: En el seminario hablaremos sobre los nuevos flujos de tarificación, y nos enfocaremos en la inclusión del análisis geográfico en el proceso de modelado para optimizar la extracción del riesgo en modelos de Machine Learning.

Description: Can you answer the question, 'What are the chances we will lose more than $1 million?' without saying, 'It depends'? If you miss a projection, can you estimate the chances that the miss was due to random variation versus an incorrect projection? Listen in as presenters demonstrate how to answer these questions and others using total risk analysis. Total risk analysis includes quantifying both the random variation risk and the projection risk associated with actuarial functions like pricing and reserving. After attending this session, you will be able to describe total risk analysis and to apply to many health actuarial functions.

Description: This session includes a new idea based on dynamic treatment regime work (OWL) and integrating cost into this work. This will enable identifying the best treatment for a patient based on both outcomes and cost. This is novel for actuaries because in previous analysis we have used cost only in the after-analysis, whereas here we use it in the actual analysis and treatment identification. Moreover, this analysis provides a way to consider multiple treatments for a patient (including the no treatment option) and choosing among those multiple treatments, for both outcomes and cost. This session will share the background theory and set up a case study. The case study will parallel what is in the analysis in the book by Ian Duncan 'Predicting Hospital Readmission with Case Management Recommendation.' This analysis will then go further to compare a situation where there are multiple potential case managers. Also, this will potentially explore care pathways and choosing the best care pathway for a patient based on health outcomes and cost combined.

Description: "A crucial importance in forecasting is to be able to distinguish cases when temporary slowdowns in health care utilization are followed by a “rebound” period of higher utilization. Come explore an analysis of a new mathematical model describing the return-of-care process. By means of simulation and case studies using the R programming language, the relationship between the visibility of these effects and the endogenous variance of the utilization time series is explored. After attending this session, you will be able to: Describe the parameters and mathematical form of the model Apply the model to real-world utilization data"

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.