Evaluating Representativeness in Healthcare Claims Data: A Framework for AI Fairness in Actuarial Applications

Evaluating Representativeness in Healthcare Claims Data: A Framework for AI Fairness in Actuarial Applications

Author: Research Insights August 21, 2026 Duration: 20:19

In this episode of the Research Insights Podcast, Lisa Schilling, Director of Practice Research at the Society of Actuaries Research Institute, speaks with Dr. Rob Lieberthal, lead author of Evaluating Representativeness in Healthcare Claims Data: A Framework for Representativeness-Based Fairness in Actuarial Applications of AI.

Their discussion explores why strong overall model performance does not necessarily mean an AI or machine learning model performs equitably across populations. Dr. Lieberthal explains how gaps in healthcare claims data can affect rural, lower-income, underdiagnosed, and other populations—and why actuaries should examine representativeness before relying on model results.

Listeners will learn about the report's three-stage bias assessment covering input bias, model bias, and application bias; examples involving geographic representation, missing data, and intersectionality; and practical approaches for evaluating subgroup performance. The episode also highlights the companion Model Card Generator and Decision Assist Tool, which are designed to help actuaries document model limitations, compare model alternatives, and apply professional judgment throughout the modeling process.

Explore the full research report and companion resources through the Society of Actuaries Research Institute at SOA.org, and discover practical ways to strengthen fairness, transparency, and informed decision-making in actuarial applications of AI.

https://www.soa.org/resources/research-reports/2026/dei127-represent-hc-data/


Hosted by R. Dale Hall, FSA, MAAA, CERA, the Managing Director of the SOA Research Institute, Research Insights, a Society of Actuaries Podcast is a direct line to the critical studies shaping the actuarial field and related disciplines. This isn't just a summary of papers; it's a series of conversations that unpack the implications, methodologies, and real-world applications found within the Society of Actuaries Research Institute's extensive work. You'll hear discussions on recently released research reports, deep dives into studies featured at major SOA meetings, and explorations of other pivotal findings produced by the institute. Each episode is designed to translate complex data and sophisticated models into accessible insights, whether you're a practicing actuary, a professional in a related financial or risk management field, or simply someone with a keen interest in the science of uncertainty. The podcast serves as an essential audio companion for anyone looking to stay informed on the latest evidence-based approaches to insurance, retirement, finance, and health. By tuning in, you gain a clearer understanding of how rigorous research informs better business decisions and public policy. Occasional guest hosts bring additional perspectives, ensuring a well-rounded examination of each topic. For those committed to continuous learning and professional self-improvement, this series provides a thoughtful and substantive resource, naturally integrating detailed analysis with broader educational context.
Author: Language: English Episodes: 50

Research Insights, a Society of Actuaries Podcast
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