SOA Predictive Analytics

That’s the power of
predictive analytics in healthcare.

Using predictive modeling, actuaries are working to solve emerging health challenges—analyzing massive amounts of data to make connections, identify trends, evaluate future risk and, ultimately, help healthcare institutions develop smarter clinical protocols that improve patient outcomes and profitability.

With deep analytics expertise and a passion for using data to make a greater impact, actuaries are thriving in healthcare—helping organizations of all sizes and in every sector understand the bigger picture of risk to streamline operations, gain a competitive edge and ensure success.

That’s the power of
predictive analytics in healthcare.

The impact of actuaries working in predictive analytics can be felt across the healthcare continuum.

Facing unprecedented challenges, healthcare organizations are turning to actuaries with expertise in predictive analytics to help them make strategic decisions and prepare for the future with confidence.

Applications of Predictive Analytics in the Provider Setting:

Risk adjustment auditing and automatic analysis of discrepancies with regard to coding compliance
Care management program evaluation and risk stratification model development (alongside clinical resources) in support of population health management
Self-funded employee health plan monitoring and design; in-source pricing and reserving done with outside consultants
Cost models, reporting, and contract negotiation and reconciliation with payers within the managed care market
Reporting and modeling systems design, implementation and testing within the IT areas
Statistical analysis and support for research studies and clinical trials
Unexpected provider behavior
Address public health by targeting populations for specific interventions
Track and predict pools of infection
Fraud, waste and abuse

HEALTH INSURANCE COMPANIES

Applications of Predictive Analytics in the Payer Setting:

Risk adjustment, underwriting and pricing
Trend analysis
Anticipating selection by plan design
Assumptions
Consumer propensities
Producer management
Optimize budget allocation
Case finding (medical management)
Geographical practice variation and their implications
Target population for specific interventions
Track and predict pools of infection such as sepsis and septicemia
Manage and offer a personalized customer experience

PHARMACEUTICAL COMPANIES

Applications of Predictive Analytics in the Pharmaceutical Setting:

Target marketing and sales
Research and development
Specialty pharmacy management
Provider reporting
Pre-clinical trials
Opioid abuse and management
Patient profiling for safety and care management
Unexpected drug/drug interactions
Fraud, waste and abuse
Optimize business operations

Surgeons saved his life.

Actuaries helped save him a readmission.

That’s the power of
predictive analytics in healthcare.

Actuaries are making the connections that make healthcare better.

That’s the power of
predictive analytics in healthcare.

Actuaries are making the connections
that make healthcare better.

The impact of actuaries working in predictive analytics can be felt across the healthcare continuum.

+ HOSPITALS AND HEALTH SYSTEMS

+ HEALTH INSURANCE COMPANIES

+ PHARMACEUTICAL COMPANIES

HOSPITALS AND HEALTH SYSTEMS

Applications of Predictive Analytics in the Provider Setting:

HEALTH INSURANCE COMPANIES

Applications of Predictive Analytics in the Payer Setting:

PHARMACEUTICAL COMPANIES

Applications of Predictive Analytics in the Pharmaceutical Setting:

What is an actuary?

Why an actuary?

How does actuarial training make us different?

DOWNLOAD

predictive analytics
articles

WATCH

Dale Hall discuss
predictive analytics essays

READ

Q&A with Ian Duncan

In the right hands, data makes a difference.

Meet SOA actuaries who are making big data and predictive analytics work harder for healthcare.

“Actuaries belong in this field. There is a real and almost urgent need for them to help manage all kinds of risk in the provider arena.”

— Lillian L. Dittrick,
FSA, MAAA, UnityPoint Health®

“The technology that’s spawning in healthcare leads to incredibly interesting and challenging data for actuaries to work with. There is unprecedented opportunity for actuaries today.”

— Andrew M. Webster,
MS, ASA, MAAA

“Actuaries thrive in the realm of the uncertain. It’s one of the many reasons they are able to solve healthcare industry problems that have never been seen before.”

— Syed Mehmud,
ASA, FCA, MAAA, Wakely Consulting Group

Resources

Thought Leadership

News & Insights

Professional Development

Surgeons saved his life.

Actuaries helped save him a readmission.

That’s the power of predictive analytics in healthcare.

Actuaries are making the connections that make healthcare better.

That’s the power of predictive analytics in healthcare.

Actuaries are making the connections that make healthcare better.

The impact of actuaries working in predictive analytics can be felt across the healthcare continuum.

+ HOSPITALS AND HEALTH SYSTEMS

+ HEALTH INSURANCE COMPANIES

+ PHARMACEUTICAL COMPANIES

HOSPITALS AND HEALTH SYSTEMS

Applications of Predictive Analytics in the Provider Setting:

HEALTH INSURANCE COMPANIES

Applications of Predictive Analytics in the Payer Setting:

PHARMACEUTICAL COMPANIES

Applications of Predictive Analytics in the Pharmaceutical Setting:

What is an actuary?

Why an actuary?

How does actuarial training make us different?

DOWNLOAD

predictive analytics articles

WATCH

Dale Hall discuss predictive analytics essays

READ

Q&A with Ian Duncan

In the right hands, data makes a difference.

Meet SOA actuaries who are making big data and predictive analytics work harder for healthcare.

“Actuaries belong in this field. There is a real and almost urgent need for them to help manage all kinds of risk in the provider arena.”

— Lillian L. Dittrick, FSA, MAAA, UnityPoint Health®

“The technology that’s spawning in healthcare leads to incredibly interesting and challenging data for actuaries to work with. There is unprecedented opportunity for actuaries today.”

— Andrew M. Webster, MS, ASA, MAAA

“Actuaries thrive in the realm of the uncertain. It’s one of the many reasons they are able to solve healthcare industry problems that have never been seen before.”

— Syed Mehmud, ASA, FCA, MAAA, Wakely Consulting Group

Resources

Thought Leadership

News & Insights

Professional Development

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That’s the power of
predictive analytics in healthcare.

That’s the power of
predictive analytics in healthcare.

Actuaries are making the connections
that make healthcare better.

predictive analytics
articles

Dale Hall discuss
predictive analytics essays

— Lillian L. Dittrick,
FSA, MAAA, UnityPoint Health®

— Andrew M. Webster,
MS, ASA, MAAA

— Syed Mehmud,
ASA, FCA, MAAA, Wakely Consulting Group