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Adaptive multi-fidelity optimization with fast learning rates Enhancing AI and Dynamical Subseasonal Forecasts with Probabilistic Bias Correction Sample Complexity Bounds for Stochastic Shortest Path with a Generative Model The Harder Path: Last Iterate Convergence for Uncoupled Learning in Zero-Sum Games with Bandit Feedback Stylistic-STORM (ST-STORM) : Perceiving the Semantic Nature of Appearance Collective Kernel EFT for Pre-activation ResNets PRIM-cipal components analysis One-Shot Generative Flows: Existence and Obstructions Structural interpretability in SVMs with truncated orthogonal polynomial kernels Amortized Optimal Transport from Sliced Potentials MinShap: A Modified Shapley Value Approach for Feature Selection Unsupervised feature selection using Bayesian Tucker decomposition Multi-User mmWave Beam and Rate Adaptation via Combinatorial Satisficing Bandits Best of both worlds: Stochastic & adversarial best-arm identification Scalable Model-Based Clustering with Sequential Monte Carlo Expert-Guided Class-Conditional Goodness-of-Fit Scores for Interpretable Classification with Informative Missingness: An Application to Seismic Monitoring Lightweight Geometric Adaptation for Training Physics-Informed Neural Networks Gating Enables Curvature: A Geometric Expressivity Gap in Attention Zeroth-Order Optimization at the Edge of Stability Differentially Private Conformal Prediction CLion: Efficient Cautious Lion Optimizer with Enhanced Generalization Generative Augmented Inference Improving Machine Learning Performance with Synthetic Augmentation PAC-MCTS: Bias-Aware Pruning for Robust LLM-Guided Search and Planning Path-Sampled Integrated Gradients Heat and Matérn Kernels on Matchings Doubly Outlier-Robust Online Infinite Hidden Markov Model Momentum Further Constrains Sharpness at the Edge of Stochastic Stability Multistage Conditional Compositional Optimization BOAT: Navigating the Sea of In Silico Predictors for Antibody Design via Multi-Objective Bayesian Optimization
Accurate and Interpretable Machine Learning for Transpare...
Rohun Kshirsagar, Li-Yen Hsu, Vatshank Chaturvedi, Charles H. Gr · 2020-09-23 · via stat.ML updates on arXiv.org

Health insurance companies cover half of the United States population through commercial employer-sponsored health plans and pay 1.2 trillion US dollars every year to cover medical expenses for their members. The actuary and underwriter roles at a health insurance company serve to assess which risks to take on and how to price those risks to ensure profitability of the organization. While Bayesian hierarchical models are the current standard in the industry to estimate risk, interest in machine learning as a way to improve upon these existing methods is increasing. Lumiata, a healthcare analytics company, ran a study with a large health insurance company in the United States. We evaluated the ability of machine learning models to predict the per member per month cost of employer groups in their next renewal period, especially those groups who will cost less than 95\% of what an actuarial model predicts (groups with "concession opportunities"). We developed a sequence of two models, an individual patient-level and an employer-group-level model, to predict the annual per member per month allowed amount for employer groups, based on a population of 14 million patients. Our models performed 20\% better than the insurance carrier's existing pricing model, and identified 84\% of the concession opportunities. This study demonstrates the application of a machine learning system to compute an accurate and fair price for health insurance products and analyzes how explainable machine learning models can exceed actuarial models' predictive accuracy while maintaining interpretability.