Many would contend that the United States healthcare system should be moving towards a state of health equity. Here, every individual is not disadvantaged from achieving their true health potential. However, a variety of barriers currently exist that restrict individuals across the country from attaining equitable health outcomes; one of these is the social determinants of health (SDOH). The SDOH are non-medical factors that influence the health outcomes of an individual such as air pollution, food insecurity, and transportation accessibility. Each of these factors can influence the critical illnesses and health outcomes of individuals and, in turn, diminish the level of health equity in affected areas. Further, the SDOH have a strong correlation with lower levels of health outcomes such as life expectancy, physical health, and mental health. Despite having influenced the United States health care system for decades, the industry has only begun to address its influences within the past few years. Through exploration between the associations of the SDOH and health outcomes, programming and policy-making can begin to address the barrier to health equity that the SDOH create.

The United States spends far more on healthcare than other developed countries, and it is increasing at a rapid pace that places intense financial pressure on the American public. The high levels of spending are not attributable to increased quality of care or a healthier general population. Rather, the culprits are a combination of uniquely American social and cultural factors that increase the prevalence of chronic illness coupled with a large and complex healthcare industry that has a multitude of stakeholders, each with their own motivations and expense margins that inflate prices. Additionally, rampant lack of transparency, overutilization and low-quality care contribute to unnecessarily frequent and expensive payments. Public and private institutions have implemented legislation and programs that provide temporary relief, but powerful lobbying efforts by healthcare-related organizations and a general American aversion to high government involvement have prevented the United States from creating effective, long-lasting reform.

The objective of this study is to build a model using R and RStudio that automates ratemaking procedures for Company XYZ’s actuaries in their commercial general liability pricing department. The purpose and importance of this objective is to allow actuaries to work more efficiently and effectively by using this model that outputs the results they otherwise would have had to code and calculate on their own. Instead of spending time working towards these results, the actuaries can analyze the findings, strategize accordingly, and communicate with business partners. The model was built from R code that was later transformed to Shiny, a package within RStudio that allows for the build-up of interactive web applications. The final result is a Shiny app that first takes in multiple datasets from Company XYZ’s data warehouse and displays different views of the data in order for actuaries to make selections on development and trend methods. The app outputs the re-created ratemaking exhibits showing the resulting developed and trended loss and premium as well as the experience-based indicated rate level change based on prior selections. The ratemaking process and Shiny app functionality will be detailed in this report.