Tenth Annual Modeling Web Summit - a prolonged peek into healthcare analytics, risk adjustment and predictive modeling in 2018

      
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Tenth Annual Modeling Web Summit - a prolonged peek into healthcare analytics, risk adjustment and predictive modeling in 2018
 
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Overview

Healthcare organizations are increasingly reliant on leveraging analytics, risk adjustment and predictive modeling in order to achieve their objectives required to move forward into the next decade of this century. Healthcare executives throughout the organization must continue to expand their understanding of the key current issues and concepts in this arena in order to effectively lead and best position themselves for the future.

The Tenth Annual Predictive Modeling Web Summit features a 90 minute live webinar with three sessions featuring expert national speakers that provides essential knowledge both for those intimately involved with predictive analytics, as well as those with key executive responsibilities throughout the organization.

Ian Duncan, FSA, FIA, FCIA, MAAA, Adjunct Associate Professor of Actuarial Statistics, Department Of Statistics and Applied Probability, University of California, Santa Barbara and President, Santa Barbara Actuaries, Inc. will discuss the application of healthcare risk adjustment and predictive modeling to key current topics in 2018, and will overview health risk, clinical identification algorithms for diagnostic grouping and the use of grouper models before moving into data mining concepts and common approaches used by modelers. Ian will explore predictive modeling and risk-adjustment case studies through examples from Medicaid, Medicare Advantage, ACA Exchanges, ACOs, disability and depression diagnosis.

Ksenia Whittal, FSA, MAAA, Consulting Actuary, Milliman and Abigail Caldwell, FSA, MAAA, Milliman, provide an examination of predictive models to determine if an enhanced model can better identify individuals with rising risk relative to traditional prospective risk adjustment models; and also evaluate the ability of these models to select members when costs increase in the future year.

David Bodycombe, ScD, MSc, Director ACG System Research, The Johns Hopkins ACG System will discuss Johns Hopkins research regarding the development and testing of three measures of high-risk prescription opioid use that can be derived from pharmacy claims data. The metrics for patient future costs and predictors of future opioid use  has potential implications for opioid abuse mitigation interventions and care management programs. The measures can be applied with EHR or prescription drug monitoring program data as well, and is being used to develop more advanced predictive models that can be used to help identify a wider range of populations and individuals in need of interventions that may potentially save their lives.

The event also includes two on-demand sessions providing research findings, with Millman's Rong Yi, PhD exploring various aspects of risk sharing as it pertains to value-based contracting for commercial lines of business and addresses the relationship between data accuracy, risk adjustment and measurement of performance metrics in her presentation: Provider Coding Accuracy in Commercial Value Based Contracts; and Milliman's T. Scott Bentley and Steve Phillips presenting their research and insights on Milliman's triennial study, summarizing estimated U.S. average costs per member per month, billed charges, and utilization related to the 30 days prior and 180 days after transplant admission for organ and tissue transplants, during their presentation: Milliman Research: 2017 U.S. Organ and Tissue Transplant Costs.

Position your organization beyond 2018 in the healthcare predictive analytics landscape. Join us for the Tenth Annual Predictive Modeling Web Summit on Thursday, July 12th, 2018, and participate in the live ninety-minute national webinar, additional on-demand faculty sessions, predictive modeling e-poll and more, featuring national experts providing a prolonged peek into healthcare analytics, risk adjustment and predictive modeling in 2018, plus receive the current issue of Predictive Modeling News.
 

Webinar Agenda
Thursday, July 12, 2018
1:00 p.m. to 2:30 p.m. Eastern (10:00 a.m. - 11:30 a.m. Pacific)
Click here to find out what time your event starts in your time zone.
  • 1:00 pm - 1:30 pm  Healthcare Risk Adjustment and Predictive Modeling in 2018 - Ian Duncan, FSA, FIA, FCIA, MAAA, Adjunct Associate Professor of Actuarial Statistics, Department Of Statistics and Applied Probability, University of California, Santa Barbara and President, Santa Barbara Actuaries, Inc.  
  • 1:30 pm - 2:00 pm  Rising risk: Maximizing the odds for care management -Ksenia Whittal, FSA, MAAA,
    Consulting Actuary, Milliman, and Abigail Caldwell, FSA, MAAA, Consulting Actuary, Milliman
  • 2:00 pm - 2:30 pm  Leveraging Prescription Data to Derive Future Costs and Predicators Regarding Opioid Abuse Patients - David Bodycombe, ScD, MSc, Director ACG System Research, The Johns Hopkins ACG System
On-Demand Sessions & More
On-Demand Video Presentations with audio and synchronized slide advancement:
  • Provider Coding Accuracy in Commercial Value Based Contracts - Rong Yi, PhD, Principal and Healthcare Management Consultant, Milliman (58 minutes)
  • Milliman Research: 2017 U.S. Organ and Tissue Transplant Costs - T. Scott Bentley, FSA, MAAA, Principal, Consulting Actuary, Milliman Inc.; and Steve Phillips, FSA, MAAA, Consulting Actuary, Milliman, Inc. (40 minutes)
  • Plus other Web Summit features including a Predictive Modeling Article Library, an exclusive predictive modeling e-poll, and the current edition of Predictive Modeling News
Learning Objectives
Participants will be able to:
  1. Grasp current significant issues and concepts critical to the application of healthcare analytics, risk adjustment and predictive modeling.
  2. Explore application of risk adjustment and predictive modeling through brief case studies involving key topics.
  3. Examine the potential of enhanced models to identify patients with risking risk.
  4. Consider the impact and implications of analyzing prescription data to determine future patient costs and serve as predicators regarding opioid abuse patients.
  5. Review various aspects of risk sharing as it pertains to value-based contracting and the relationship between data accuracy, risk adjustment and measurement of performance metrics.
  6. Obtain relevant data and insights regarding organ and tissue transplant costs.
  7. Experience e-learning at the attendees' convenience, with on-demand sessions, article library, and other online Summit features available 24/7.
  8. Engage in interactive learning through live webinar providing online question submission, attendee surveys, feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.
Who Should Attend
Interested attendees would include:
  • C-Suite Executives
  • Analytics and Informatics Executives and Staff
  • Actuarial and Underwriting Executives and Staff
  • Risk Adjustment Executives and Staff
  • Statisticians and Data Analysts
  • Planning and Strategic Executives and Staff
  • Medical Directors
  • Clinical Executives
  • Care Management Executives
  • Population Health Executives
  • Pharmacy Benefit Executives
  • Health Benefit Managers
  • Provider Network Executives
  • Innovation and Transformation Executives
  • Business and Market Intelligence Staff
  • Health Care Economists
  • Other Interested Parties

Attendees would represent organizations including

  • Health Plans
  • Hospital Systems
  • Provider Networks
  • Accountable Care Organizations
  • Medical Groups
  • Care Management Organizations
  • Government
  • PBMs
  • Third Party Administrators
  • Employers
  • Life Sciences Organizations
  • Consulting Organizations
  • Business Processing Organizations
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
Registration
  Individual Registration Fee: $295. Post Event Materials including videos syncing slides and recorded audio, presentation pdf files, and e-poll survey report: $45 for attendees; $355 for non-attendees after the event. Register online or download the event flyer.  
     
 
Register Now   Click here to register or call 209.577.4888. Corporate Site licensing also available. We look forward to your attendance!
 
 
Faculty
 
Ian Duncan

Ian Duncan
,
FSA, FIA, FCIA, MAAA
Adjunct Associate Professor of Actuarial Statistics, Department Of Statistics and Applied Probability, University of California, Santa Barbara and President, Santa Barbara Actuaries, Inc.

 
  Ian Duncan, FSA, FIA, DCIA, FCA, CSPA, MAAA is an Adjunct Associate Professor of Actuarial Statistics in the Dept. of Statistics and Applied Probability at the University of California, Santa Barbara and the President of Santa Barbara Actuaries Inc. He has over 30 years of experience in healthcare and insurance product design, management, financing, pricing and delivery and has founded two previous companies to perform predictive modeling and outcomes analysis for healthcare. He is a frequent speaker about health outcomes, predictive modeling and risk adjustment.

Mr. Duncan holds a post-graduate degree in economics from Balliol College, Oxford and is a Fellow of the Society of Actuaries, the Institute of Actuaries (London), the Canadian Institute of Actuaries and the Conference of Consulting Actuaries.

Ian is author of a number of books and peer-reviewed papers. His latest book,  Healthcare Risk Adjustment and Predictive Modeling, Second Edition, published by ACTEX Learning, has just been released in May 2018.


 


Ksenia Whittal

Ksenia Whittal, FSA, MAAA
Consulting Actuary
Milliman
 

Ksenia is a consulting actuary with the Denver Health practice of Milliman. She joined the firm in 2005.Ksenia's primary focus is on predictive modeling and lifestyle-based analytics application to underwriting and disease management. This work includes consulting to healthcare plans on the use of lifestyle-based data to augment underwriting decisions and identify individuals for disease management and wellness initiatives. Lifestyle-based analytics plays an especially strong role in risk selection in the small/medium group market, and will integrate well with other risk selection approaches such as risk adjusters, IntelliScript, and medical underwriting.

Most recently, Ksenia has been managing the technical development of Milliman Advanced Risk Adjusters (MARA), which was released in 2010. MARA utilizes Milliman's existing actuarial and clinical expertise and is well suited for advanced applications of risk adjustment in healthcare budgeting, pricing, payment, stratifying risks, and analytic reporting.

Ksenia's work in long-term care includes pricing, product development, valuations of blocks of business, filing, and large group offerings. Other recent projects include benchmarking and rate development for health plans.

Ksenia is a Fellow, Society of Actuaries, and a Member, American Academy of Actuaries. She received a BM (with distinction), Honors Actuarial Science, University of Waterloo.
 


Abigail Caldwell

Abigail Caldwell, FSA, MAAA
Consulting Actuary
Milliman
 

Abigail is a consulting actuary with the Denver office of Milliman. She joined the firm in 2011. Abigail has extensive ACA commercial pricing experience and has worked with multiple health plans on both pricing and reviewing rates. She has also assisted various consumer-oriented and operated plans with the pricing and filing for individual and small group exchange products as well as provided other actuarial support such as monitoring emerging plan experience, reserving, and network contracting analysis.

She has assisted with applications for CMMI grants for innovations in healthcare, focusing on the cost savings associated with integrated medical and behavioral care. She has also worked with a CMMI grant award winner to model and quantify the savings associated with its integrated ambulatory care program.

Abigail is involved in the annual Medicaid capitation rate setting process with the state of Colorado and the behavioral health organizations. She has worked with several insurers to build statistical models to aid with the identification of high-opportunity members. She has also assisted with the development of Milliman's Medical Underwriting Guidelines.

Abigail is a Fellow, Society of Actuaries, and a Member, American Academy of Actuaries. She has a BS degree (summa cum laude) in Mathematics from the University of Alabama.

 

David Bodycombe, Sc.D.

David Bodycombe
,
 ScD, MSc
Director ACG System Research,  The Johns Hopkins ACG System
 
 

Dr. Bodycombe is responsible for formulating and overseeing the R&D agenda of the lab. He is actively engaged in all phases of moving the work of the lab from initial conceptualization, methodological design, and analytics, to deployment and publication. He has more than 40 years of experience in statistics, the design and construction of large clinical and epidemiologic databases, statistical programming, and information technology applications development.

Prior to joining the Johns Hopkins Bloomberg School of Public Health faculty, Dr. Bodycombe served as Vice President of Analytics for Premier Inc., a major quality improvement and supply chain management organization. In addition, he was Director of Research for the American College of Cardiology. He has also consulted on a wide range of projects concerning prison healthcare, Native American sanitation programs, and HIV in minority communities.

Dr. Bodycombe holds a ScD in Health Policy and Management and a Baccalaureate degree in Biology from the Johns Hopkins University, as well as an MSc in Biostatistics from Georgetown University. 


Rong Yi, PhD

Rong Yi, PhD
Principal and Healthcare Management Consultant, Milliman
 

Rong is a Principal with the New York office of Milliman. She joined the firm in 2009. Rong has extensive experience in healthcare analytics, especially in the fields of in risk adjustment and predictive modeling. She has worked with private insurers, providers, employers, government agencies, and researchers in the United States and other parts of the world. She is a frequent speaker at professional and academic conferences.

Rong has done pioneering work in a number of areas, including state-based risk adjustment programs for the commercial markets and for the uninsured population, risk-based provider contracting and profiling, risk-adjusted episodes of care, and predictive models for a variety of business applications. She works with clients to implement analytic methodologies and tools into their business process, and in this capacity assists clients to develop business rules and operational guidance to ensure program operational success. Most recently, she is the lead consultant for the Massachusetts ACA risk adjustment program, and led the development, implementation and operations of the Massachusetts state-based risk adjustment methodology for the commercial individual and small group market. 

Before joining Milliman, Rong was a major contributor to commercial and governmental risk adjustment systems in wide use today. 
 


T. Scott Bentley

T. Scott Bentley,
FSA, MAAA, Principal, Consulting Actuary
Milliman
 
 

Scott is a principal and consulting actuary with the Milwaukee office of Milliman. He joined the firm in 1986. Scottís area of expertise is healthcare programs, including individual and group Medicare Supplement insurance, long-term care insurance, managed care plans, and group and individual major medical. He has assisted clients with plan design, pricing, liability estimation, experience analysis, and actuarial projections. Scott has advised insurance companies, HMOs, and other managed care organizations.

Scott is a Fellow, Society of Actuaries, and a Member, American Academy of Actuaries. He has a BS in Business and Mathematics from the University of Wisconsin-Eau Claire. 


Steve Phillips

Steve Phillips,
FSA, MAAA
Consulting Actuary
 Milliman
 

Steve is a consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2014. Steveís area of expertise is commercial and managed healthcare programs. He advises various entities, including insurance companies and employers. Steve primarily focuses on the group and individual commercial, Medicare supplement, and dental markets. Steve also has expertise in Medicare Part D creditable coverage and the retiree drug subsidy program. He has assisted clients with healthcare reform strategy, product development, pricing, reserving, and experience analyses. 

Examples of Steveís experience include: Advising clients on ACA pricing and product strategy and preparing small group and individual filings in six states; Completing year-end statements of actuarial opinion, including risk adjustment accruals and premium deficiency reserve analyses; Estimating monthly reserves for medical, drug, short-term disability, and dental products; Conducting Medicare Part D creditable coverage and retiree drug subsidy analyses; and Developing the transplant estimates in Millimanís Health Cost Guidelines

Prior to joining Milliman, Steve had seven years of experience working for two large insurance carriers, where he focused on reserving, financial reporting, provider networks, enterprise risk management, and economic capital modeling. Steve is a 
Fellow, Society of Actuaries, and a Member, American Academy of Actuaries. He has a BBA in Actuarial Science from the University of Wisconsin.

 

 
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