Yet with little recognizable slowing in healthcare costs, health plans are looking at new ways to lower their exposure to medical expenses. Turns out they're sitting on a treasure trove, so to speak: terabytes upon terabytes of medical data.
This reminds me of a Colorado tour guide who would point to some indiscriminate landscape and quip, "There's a billion dollars worth of gold in that thar hillside," to which everyone would hem and haw. And with a smirk, he'd go on to proclaim, "But it would cost a billion and a half to get it out."
With today's price of gold, perhaps he's underestimating its worth.
I assure you, health plans aren't taking the value of their data so lightly. And with the help of some innovative companies, they are mining this information with great expectation of significantly lowering healthcare costs.
Among them, benefits management firm BridgeHealth Medical is aggressively targeting their surgery niche with a predictive modeling tool called Early Indicators that extracts relevant, HIPAA-compliant claims data from health plan's or employer's database and estimates the probability a certain member population will require future surgery.
An oversimplified example might be someone who recently received at CT scan of their knee and it was determined that some damage exists. With a doctor's orders for physical therapy to correct the condition, the patient might attend a few sessions but soon tire of the process and quit.