the role of predictive analytics · 2019-10-25 · competing on analytics 30 . paid liability risk...
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The Role of Predictive Analytics
Wu-Chyuan (Gary) Gau, PhD, ASA, MAAA
05/16/2017
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Agenda
• What Is Predictive Analytics?
• Actuarial Traditional Functions
• Post-Reform Marketplace Background
• Predictive Modeling Methodology
• Impact of Risk Modeling
• Data Massage
• Competing on Analytics
• Healthcare Predictive Modeling Opportunities
• Predictive Analytics in Other Actuarial Areas
• Machine Learning Algorithms Cheat Sheet
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What is Predictive Analytics?
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Traditional Statistics
•Statistics is a scientific way of studying how to:
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Collect Summarize Inference
Data.
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Predictive Analytics
• Predictive analytics encompasses a variety of statistical techniques from predictive modeling, machine learning, and data mining that analyze current and historical facts to make predictions about future or otherwise unknown events
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Source: https://en.wikipedia.org/wiki/Predictive_analytics
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Advanced Analytics
Gartner defines Advanced Analytics as: “the analysis of all kinds of data using sophisticated quantitative methods (for example, statistics, descriptive and predictive data mining, simulation and optimization) to produce insights that traditional approaches to business intelligence (BI) — such as query and reporting — are unlikely to discover.” *
*http://www.applieddatalabs.com/content/new-gartner-magic-
quadrant-advanced-analytics-platforms
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Actuarial Traditional Functions
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Actuarial Traditional Functions
• Pricing
• Reserving
• Financial Performance
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Financial Projection
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Incurred
Claim
Incurred Date Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16
Jan-16 $14,081,127
Feb-16
Mar-16
Apr-16
May-16
Jun-16
Jul-16
Aug-16
Sep-16
Oct-16
Nov-16
Dec-16
For Illustrative Purpose Only.
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Post-Reform Marketplace Background
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Where We Were
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Interest Outreach Underwriting
Consumer Data
Risk Selection
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Where We Are
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Interest/Logging
In Outreach
Guaranteed Issue
Consumer Data
Risk Management
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Where We Are Going
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Consumer Experience,
Needs, Wants,
Preferences
Insurer Experience
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2010 FL Health Insurance Coverage
Sector Population (million) Uninsured 4.3
Medicaid/SCHIP (Non-Risk) 1.3 Medicaid/SCHIP (Risk) 1.3
TRICARE/Other 1.2 Medicare 2.4 Under 65 0.8
Small Group 2.2 Large Group 5.4
14 For Illustrative Purpose Only.
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Predictive Modeling Methodology
1. Define the business problem.
2. Translate business problems into predictive modeling problems.
3. Select appropriate data.
4. Get to know the data.
5. Create a model set.
6. Fix problems with the data.
7. Transform the data.
8. Build models.
9. Assess models.
10. Deploy models.
11. Assess results.
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Consumer Data
• Age
• Gender
• Household income
• Hobby
• Music
• Pets
• Sports
• Read
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Classification and Segmentation
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Impact of Risk Modeling
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Loss Ratio Risk 1 Risk 2 Risk 3 Overall
LBA 1 79% 73% 73% 74%
LBA 2 81% 79% 75% 77%
LBA 3 99% 93% 82% 87%
Overall 87% 82% 77% 80%
For Illustrative Purpose Only.
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Ensemble
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Proxy Model
1 2 3 4 5 Total
Bu
ild U
p M
od
el
1 66.7% 75.5% 76.8% 82.0% 79.3% 73.0%
2 68.8% 72.7% 77.1% 79.6% 87.6% 75.6%
3 67.9% 73.4% 72.6% 80.2% 82.7% 75.6%
4 69.9% 83.1% 78.9% 81.7% 83.3% 80.8%
5 84.8% 81.1% 88.9% 89.5% 93.2% 91.1%
Total 68.4% 76.1% 77.8% 82.8% 89.1% 80.0%
For Illustrative Purpose Only.
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Profitability
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Profit
Decile
Mean
Risk
Score
Mean Allowable
Rating Factor
Loss
Ratio
1 1.83 2.048 97.1%
2 1.71 1.823 87.0%
3 1.51 1.729 84.9%
4 1.52 1.739 82.1%
5 1.47 1.659 81.8%
6 1.33 1.539 77.7%
7 1.38 1.534 77.3%
8 1.39 1.576 72.7%
9 1.55 1.621 69.3%
10 2.07 1.995 66.9%
Total 1.58 1.726 80.0%
For Illustrative Purpose Only
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0.00
0.50
1.00
1.50
2.00
2.50
3.00
M1
0
M2
1
M1
4
M2
4
M3
2
F10
M2
8
F11
F12
F13
M2
9
M5
1
M5
2
M4
8
M5
4
M5
5
F25
M5
7
F33
F34
F42
F51
M6
4
M6
5
F29
M5
9
F55
F48
F64
M7
2
F66
F49
M7
5
F76
F82
F90
M8
1
F86
M8
4
M8
5
M8
6
F96
F97
M9
4
F99
Re
lati
vity
Gender, Age Band, and Lifestyle Based Risk Profile
Zone of Opportunities?
21 For Illustrative Purpose Only
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Data Massage
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Categorical Variables
• Not all data mining tools can handle categorical inputs well. –Decision tree – OK
–NN – not Ok
–Logistic regression – not OK
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Postal Carrier Route
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Postal Carrier Routes in ZIP Code
32246 Jacksonville, Florida
Route Type of Business Apartment Residential Avg Household Avg Property
Route Count Count Count Income Value
C001 City 104 0 402 $53,906 $87,604
C003 City 16 332 652 $38,909 $72,367
C008 City 1 0 635 $66,709 $231,474
C013 City 1 0 614 $62,982 $99,833
C023 City 57 383 483 $49,286 $107,979
C026 City 24 965 1 $63,789 $325,942
C029 City 12 160 615 $41,921 $100,865
C033 City 69 200 454 $45,507 $79,672
C035 City 0 0 877 $64,216 $129,577
C036 City 75 585 754 $50,719 $141,914
C050 City 0 0 745 $53,179 $106,004
C053 City 104 471 428 $62,547 $106,338
C056 City 24 1037 3 $65,055 $146,883
C057 City 76 325 592 $64,857 $0
C058 City 239 780 219 $56,239 $236,262
C059 City 64 148 474 $45,998 $108,723
C063 City 197 223 170 $45,397 $119,388
C066 City 7 0 707 $54,047 $84,645
C068 City 20 86 778 $51,498 $161,574
C069 City 44 0 601 $48,736 $72,014
R036 Rural Route 1 0 500 $74,220 $227,251
R094 Rural Route 0 0 589 $63,689 $226,449
R107 Rural Route 12 0 860 $71,118 $192,187
R112 Rural Route 3 421 549 $58,061 $176,949
R116 Rural Route 2 0 648 $57,329 $196,408
R142 Rural Route 0 0 781 $60,788 $176,989
R158 Rural Route 1 0 874 $67,407 $191,619
R182 Rural Route 3 203 496 $68,592 $251,456
Overall 1,156 6,319 15,501 $57,580 $142,343
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Data Preparation I
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Data Preparation II
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Data Preparation III
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Missing Values of Input Variables
• Missing completely at random (MCAR)?
• Missing value imputation
• Missing value indicator
• Missing value patterns
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Competing on Analytics
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Paid Liability
Risk Adjustment
Risk Assessment
Actuarial Pricing
For Illustrative Purpose Only.
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Margin 1
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Margin 2
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Example: Diabetes
X Description Prevalence
A Health focused 6.66%
B Success-oriented 4.99%
C DIY 8.11%
D Undisciplined 15.40%
E Family centered 5.58%
F Poor health 15.53%
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Segmentation Prevalence
1 0.98%
2 1.74%
3 2.49%
4 3.40%
5 4.68%
6 6.39%
7 8.13%
8 10.78%
9 15.00%
10 26.67%
Example: Diabetes
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Healthcare Predictive Modeling Opportunities
• Targeted Marketing, Outreach, and Retention Strategies through Predictive Modeling
• Risk Adjustment – How to Achieve Optimal Risk Scores and Avoid Transfer Payments
• Optimizing Care Management with Innovation - Leveraging Predictive Modeling for Proactive Identification & Micro-segmentation
• Using Predictive Analytics to Optimize Product Design and Pricing Strategies
• Applying Predictive Models to Improve Quality Measures
• Using Predictive Modeling to Prevent Fraud, Waste, and Abuse
• Disease Mappings
• Methods for Evaluation of Intervention Programs
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Predictive Analytics in Other Actuarial Areas
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Areas of Expertise
Health & Life
Insurance
Pension & Defined
Benefit
Property & Casualty
Banking & Investments
Consulting
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38 Source: http://blogs.sas.com/content/subconsciousmusings/2017/04/12/machine-learning-algorithm-use/ by Dr. Li
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IT IS DIFFICULT TO MAKE PREDICTIONS,
ESPECIALLY ABOUT THE FUTURE -Danish Proverb
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