Description: Learn about key actuarial and analytic tools and methodologies used by commercial health insurance to identify and quantify drivers of healthcare cost and utilization (including wasteful and low-value ones) and risks. Use case scenarios in which these tools and methodologies apply, such as underwriting, reinsurance, medical management for population health and chronic diseases, managed care contracting, insurance market reform, provider payment reform, etc., will also be covered. Experience from the U.S., China and other parts of the world will be shared.

Description: The prospects for China's health insurance has increased significantly in 2018, incentivized by a series of favorable government policies to support the development of commercial health insurance. However, the market still lacks relatively mature products and services. Overall there is a common understanding in the industry that good coverage plus service is the foundation for health insurance future development, and product innovation plus care management is key for an insurance company to maintain sustainable development in the competition. In this presentation, Dr. Yang will discuss the market trend both at home and abroad with respect to health management as well as its impact on product design, pricing and cost control. With the development of internet and big data, today’s health actuary has a special role in taking advantage of the digital transformation and achieving a high-quality and efficient health care service model.

Description: As actuaries, we’re trained to see patterns in numbers and to design solutions that mitigate risk. But I can tell you from experience that while quantitative analysis and modeling are critical actuarial tools, looking at the numbers alone can lead to insurance products that don’t succeed in the real world the way the math says they “should.” With new digital technologies, we have more data at our fingertips than ever before, but I believe it’s equally as important to bring qualitative research methodologies into your product development process if you want to design solutions that meet real needs in the market. In this article, Amanda Turcotte shares what happens when qualitative research is neglected or ignored, what happens when you incorporate it into the product design process, and how to implement qualitative research practices in your organization.

Description: Andy Rallis delivers his speech at the presidential luncheon of the SOA 2019 SOA Annual Meeting & Exhibit in Toronto.