Actuaries can analyze healthcare trends to determine if rates are reasonable and if reserves are adequate. In this talk, we will provide a framework of methods to analyze the healthcare trend during the pandemic. COVID-19 may influence future healthcare cost trends in many ways. First, direct COVID-19 costs may increase the amount of total experienced healthcare costs. However, with the implementation of social distancing, the amount of regularly scheduled care may be deferred to a future date. There are also many unknown factors regarding the transmission of the virus. Implementing epidemiology models allows us to predict infections by studying the dynamics of the disease. The correlation between infection amounts and hospitalization occupancies provide a methodology to estimate the amount of deferred and recouped amounts of regularly scheduled healthcare costs. Thus, the combination of the models allows to model the healthcare cost trend impact due to COVID-19.

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 Mack model and the Bootstrap Over-Dispersed Poisson model have long been the primary modeling tools used by actuaries and insurers to forecast losses. With the emergence of faster computational technology, new and novel methods to calculate and simulate data are more applicable than ever before. This paper explores the use of various Bayesian Monte Carlo Markov Chain models recommended by Glenn Meyers and compares the results to the simulated data from the Mack model and the Bootstrap Over-Dispersed Poisson model. Although the Mack model and the Bootstrap Over-Dispersed Poisson model are accurate to a certain degree, newer models could be developed that may yield better results. However, a general concern is that no singular model is able to reflect underlying information that only an individual who has intimate knowledge of the data would know. Thus, the purpose of this paper is not to distinguish one model that works for all applicable data, but to propose various models that have pros and cons and suggest ways that they can be improved upon.