Health and care: research working parties

Data is important to actuaries working within the health and care sector across the globe. Reliable data is crucial for analysis and in making informed business decisions. Many companies have internal datasets that they can use but they benefit from accessing data available from external sources. The aim of this working party is to identify datasets from across the globe that may be of value to actuaries working in health and care.

Data is important to actuaries working within the health and care sector across the globe. Reliable data is crucial for analysis and in making informed business decisions. Many companies have internal datasets that they can use but they benefit from accessing data available from external sources.

Key objectives

The aim of this working party is to identify datasets from across the globe that may be of value to actuaries working in health and care. This will include datasets that are e.g.:

• Publicly available (either with or without fee)
• Provided by private companies where a contract may be needed and use may be restricted
• Available in certain circumstances only e.g. by partnership with non-commercial entities

Key outputs

• Establish criteria of what data sources should be included
• Identify different data sources, including by contacting and working with academia to find data sources available there
• Determine appropriate metrics to collect about these data sources
• Investigate how best to access the data if it is not readily available e.g. through partnerships, considering previous experiences of IFoA working parties. Summarise the findings
• Investigate different ways of cataloguing these data sources for easy reference and choose the most appropriate method
• Create the data catalogue. For each health and care dataset identified, the catalogue should show e.g.:
  
  • Type of data (variables contained)
  • Potential applications
  • Size and duration of data
  • Indication of data quality
  • Costs/availability
  • How best to access it, if not readily available
  • Population covered
  • Limitations
• Propose how the catalogue will be kept up to date as a living document (for example, how someone could request a new data source is added).

About

Chair: Andrew Barry
Established: 2022

This working party aims to research the risk factors, incidence and mortality of diabetes along with future plausible trend scenarios which are of relevance to working actuaries.

Key objectives

To research the risk factors, incidence and mortality of diabetes along with future plausible trend scenarios which are of relevance to working actuaries.

About

Co-Chairs: Nicola Oliver and Scott Reid
Established: 2017

This working party was established to promote the development of population health management within the actuarial profession and the health sector.

Background to the working party

The Health and Care Research Sub-committee launched a member-led working party in 2018 to support the development of population health management. The National Health Service (NHS) in the UK is tackling the challenge of rising healthcare demand and constrained funding by implementing new models of care to develop integrated local healthcare systems for a defined population. To underpin delivery of the improved outcomes, better care and value for money that are being sought, it is essential that healthcare systems develop a comprehensive understanding of the health characteristics of their population – for example, current patterns of care demand, forecasting future demand, and predicting the effects of interventions. The actuarial skillset has much to offer in building and deploying such demographic, risk modelling and analytical capability, but there is currently limited awareness of this across the NHS.

Population Health Management considers the distribution of health outcomes within a population and how to impact these outcomes in the most optimal way for the group as a whole. It is a wide field and so the working party initially focussed on the specific topic of impactability modelling. The predictive risk stratification and segmentation models typically utilised in population health approaches have focused on identifying population groups that have a high risk of experiencing an adverse event, such as an unplanned hospital admission, or have a high-cost profile.

However, the success of risk stratification at the whole-population level depends not just on identifying those most at risk of an adverse event, but rather in identifying those who are most at risk and most likely to respond positively to a given intervention – i.e. to be ‘impactable’. The combination of risk stratification, impactability modelling and actuarial variability analysis can not only help to target the most promising patients for medical management, but also support the improvement of resource allocation across a local health economy.

Key objectives

The research and output of the working party has been planned in phases. Initially, a range of topics related to impactability had been explored, including:

• definition of impactability modelling – (e.g. analysis which quantifies the extent to which a defined population cohort is predicted to respond to a given healthcare intervention under specified circumstances)
• exploring an understanding of different approaches to measuring and modelling impactability including the skills, tools and techniques needed to achieve each approach
• the advantages and disadvantages of various potential approaches (both data-driven and those based on empirical evidence)
• consideration of the interactions between impactability and population risk management
• issues of public perception, inequality and ethics.

About

Chair: Alpesh Shah
Established: 2018

Fixing Social Care is back on the Government's agenda and the IFoA is expanding its research in this area to contribute to the public debate and the development of a long-term solution to the funding of adult social care.

The purpose of the working party is to contribute to the public debate around adult social care to help turn the Government's first step into a long-term sustainable solution to the funding of adult care.

Key objectives

The working party will comprise three workstreams focussing on:

• Unmet care needs and how social and private insurance can provide part of the funding solution.
• The development of uniform and objective methods of calculating care needs.
• Updating previous research on how care is funded in other developed countries and the lessons that can be learned to benefit the UK

About

Chair: Thomas Kenny
Established: 2022

The research should create a framework to assist health & care actuaries in what techniques are appropriate for their project:

• Business question or objective to address.
• Data selection: Assessment of data to understand if it will address the business question. To understand the quality of the data and suitable techniques to clean the data e.g., missingness and inconsistencies and more.
• Data exploration: to understand the data by using visualisation techniques.
• Modelling: with a focus on the business objective and to select a technique that is appropriate e.g., the credibility of data, transparency, and more.
• Communication, including interpretability of models.
• Regulations and ethics.

About

Chair: Michiel Lutejin
Established: 2023