Description: CMS provides ACOs with monthly claims data for members, including their medical visits and ACO program eligibility. This data can be divided into Membership and Claims tables through the ETL process. However, when calculating PMPY at specific levels of detail using these tables, issues arise due to unrelated dimensions, leading to inaccurate and understated results. This article presents a solution to this problem by utilizing Tableau's data blending capabilities.

Description: Every patient leaving the hospital has personal life-context circumstances that impact their chances of successful recovery and complications can be costly. Complex care management impacts over 50 percent of health care spend, with the admitted commercial population driving 37 percent of spend or $177M per 100,000 lives and the Medicare population driving 53 percent of spend or $600 million per 100,000 lives. The stakes are high, but existing care management solutions are mostly clinical and navigation call centers provide fragmented and outdated patient management systems, and do not address individual life-context. Discharged patients therefore remain underengaged and undercompliant, leading to costly complications. Innovative technology can help enable and integrate systems and existing infrastructure to leverage evidence-based contextualized care that will enhance care management, improve efficiency, and drive a better experience and outcomes for patients. This technology helps codifies life context, dynamically stratifying and engaging members digitally and telephonically helping virtual care teams to be more effective and efficient. In a recent randomized clinical trial, this technology and approach has shown a 50 percent reduction in the total cost of care, cutting the average and total cost of readmission, increasing virtual care team impact and member engagement and trust.

Description: In September 2017, the China Insurance Regulatory Commission (CIRC) issued the “C-ROSS Phase II project construction plan”, planned to be used across three years’ time, by perfecting the regulations, improving the operational mechanism and strengthening the regulatory cooperation.

Description: Dive into an overview of potential customer value propositions, trends in consumer acceptance and adoption, solving the data portability issue, potential impacts of emerging partner ships with OEMs and more within the auto insurance industry during our latest webcast. Experience interactive dialogue that will allow another dimension of thinking as industry experts provide insights and expertise. Throughout this webcast, you can expect developments in the personal lines automotive telematics-based insurance landscape that will develop a further understanding of the present and future of this industry.

Description: Join a dynamic panel of accelerated underwriting (AU) experts as they discuss results from three recent AU industry surveys, including from the Society of Actuaries (SOA) and two reinsurance studies. They'll share similarities and examine differences in their findings as they cover historical trends, current practices and their outlooks on the future of this evolving underwriting paradigm. By the conclusion of the session, you will have gained knowledge on the data and trends available from these surveys, as well as understand what AU program modifications are needed to keep pace with the industry.

Description: The key tasks of credit risk capital project under CROSS II mainly focus onL(1 )Adjustment of measurement framework; (2) Calibration of risk factors, including both credit spread risk and credit default risk;3)Introduction of concentration risk measurement; (4) Higher requirement on look-through rule.

Description: Electronic health records (EHRs) are one of the fastest-growing digital health data categories, with over 90% of carriers using or evaluating EHRs for underwriting, according to a recent Munich Re survey. This session brings you up to speed on the current (and future) state of EHRs.

Description: Volatile interest rates, repositioned investment portfolios, and stress in the banking sector are driving insurers to manage market risk and counterparty credit risk. Our experts in investments, derivatives, and hedge accounting will discuss this new market environment and its impact on hedging. The conversation will include practical case studies, including hedging future bond purchases, hedging floating-rate CLOs, and counterparty credit risk management.

Description: Using the Internet as a Pricing Tool clinical background information, defining the change in coverage, collecting data, data quality and data limitations. Issue No. 39.

Description: Learn how modernization of data, models, and technology are influencing workflows. This webcast will address how workflows are changing in response to new regulatory requirements and the impacts the changes have on modeling and end-to-end future state operating models. Industry leading actuaries will discuss: How team collaboration can increase quality and speed of reporting to internal and external stakeholders How to strengthen controls and compliance frameworks across finance and actuarial departments How to modernize actuarial input/output for strategic analysis and insights How to attract and retain top talent by improving opportunities for actuaries There will also be dedicated time to ask questions of those who have made the transition.