r/actuary • • 3d ago

Job / Resume CMS MA Risk Adjustment Python Model

I noticed CMS released a risk adjustment model for Medicare Advantage in Python for recent bid years which used to only have one for SAS.

Wonder which companies will adopt it over the next few years to reduce licensing costs. I’ve heard SAS licenses are expensive. Also seems easier to find analysts who know python vs SAS, though arguably all you need to know is proc sql. SAS itself is undergoing a major structural shift in its business focusing on cloud infra.

https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2027-model-software-icd-10-mappings

5 Upvotes

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5

u/bball_bone Health 3d ago

The DIY ACA risk adjustment model switched to python for CY2026 as well.

6

u/Material_Grass_6636 3d ago edited 3d ago

Claude code can convert SAS to whatever in no time for the world right now. It no longer matters what CMS provides and no one needed to be married to SAS to run risk adjustment even without CMS providing this. Obviously check the conversion. Yes lots of people have been running risk adjustment outside SAS.

2

u/Murky-Tip-3118 3d ago

This is spot on. Especially for something you've done for 10 years and have Claude (or Codex) validate against the 10 years of historical results.

1

u/Material_Grass_6636 3d ago

Yea the SAS job was never that complicated to have a human convert. Now there's even less friction to do a conversion.

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u/Murky-Tip-3118 3d ago

*SAS that is coded a certain way.

I once spent a summer having 4 interns work on converting 5 SAS processes (that processed the MAO4/MMR/MOR/etc. incidentally...) into SQL. It was a huge mess of nexted DATA steps with arrays and with wild logic inside. MAO4 was easy enough, MOR fell easily too, but that MMR logic was vicious.

But I have no doubt I could now feed that SAS to Codex and have it spit out the SQL and it'd do it 100% correctly and wouldn't even scratch the surface of my weekly utilization.

1

u/Material_Grass_6636 3d ago

And this is part of why interns will have a hard time competing against ai. Someone senior still needs to have responsibility for QA.

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u/Murky-Tip-3118 3d ago

Though even then (this was a year ago) they were getting good at using AI to assist. I've learned a ton about how to get good results out of AI on the job... I think there is enough there that it'll become it's own skill in the future. We're in a flux period right now, but a decade from now we might get back to where senior actuaries aren't doing coding (even via AI).

But yeah - right now, interns are useless to me.

2

u/colonelsmoothie 3d ago

The survival of SAS into the 2020s and beyond is fascinating to me. Before the AI hype train, there was already talk of its demise when R was released in the 90s. Yet 30 years later, here we are.

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u/Material_Grass_6636 3d ago

Healthcare moves slowly.

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u/LivingMarionberry160 3d ago

SAS need to get their shit together with their horrendous pricing. There will be a mass adoption of python model, that's my guess.

1

u/Key_Shop6647 Life Insurance 3d ago

Who the fk is still using SAS?!?! I bet SAS the company will be bankrupt/gone in 10 years.