RGA Industry Insights

A Breakthrough in Scoring Digital Health Data

“RGA’s comprehensive, purpose-built platform consumes structured DHD from clinical and claims data and assigns severity scores according to the RGA underwriting philosophy.”
By Sue Wehrman
Vice President, EHR Initiatives, U.S. Mortality Markets

For decades, RGA has served the industry as an underwriting leader. As new datasets and digital capabilities have emerged, we have applied that underwriting expertise – along with expertise in data science, information technology, and other disciplines – to bring advanced risk assessment solutions to market. In 2019, RGA took a landmark step forward with the launch of the industry’s first digital health data (DHD) scoring solution.

RGA began exploring DHD, which includes both electronic health records (EHR) and healthcare claims data, more than 10 years ago. In 2011, we instituted a monthly DHD newsletter, which now boasts nearly 500 subscribers, to update clients and colleagues on new developments. The knowledge gained and foundational work undertaken over the years has positioned RGA at the forefront in transforming complex DHD records into actionable underwriting insights.

Sue Wehrman, Michael Cusumano, Bob Borgstede, Janet Smith, Mark Ma, and Dianne Schuetz
From left, from Business Initiatives, U.S. Markets: Sue Wehrman, Vice President, EHR Initiatives; Michael Cusumano, Vice President and Actuary; Bob Borgstede, Project Manager; Janet Smith, Product Manager; Mark Ma, Vice President and Managing Actuary; Dianne Schuetz, Vice President of Business Initiatives.

DHD consists of hundreds of thousands of codes from multiple code sets and various medical vocabularies. Effective underwriting with DHD requires a deep understanding of risk associated with each code and careful analysis. RGA’s comprehensive, purpose-built platform consumes structured DHD from clinical and claims data and assigns severity scores according to the RGA underwriting philosophy. The end result: reams of indecipherable information converted into a readily applicable underwriting risk score.

The DHD scoring solution is part of RGA’s RiskDimensionsSM portfolio of risk assessment tools, which also added a new prescription history risk scoring model in 2019. The components of this sophisticated toolset work together to deliver a more holistic view of applicants. Insurers benefit from improved mortality risk assessment and the ability to accelerate the underwriting process with more confidence. Consumers meanwhile receive an improved buying experience and – most importantly – a greater likelihood they will acquire the coverage they need.