Getting to the Root of High-Cost Claimants

BHIThought Leadership

Among regional health plans, a recent Blue Health Intelligence (BHI) analysis found that the number of very high-cost claimants (HCCs) — members with more than $500,000 in annual claims — has nearly doubled over the last five years. Previous research shows that specialty pharmacy is a major factor in this growth. However, out-of-area claims are not a large factor in this growth.   … Read More

Stop the Bleeding: Two Ways Health Plans Can Save Money and Improve Care

BHIThought Leadership

Unnecessary care that provides little to no clinical benefit, and services performed in high-priced or inappropriate settings are costing health plans billions each year. Eliminating Unnecessary Care To determine the extent of unwarranted tests, prescriptions, and procedures being delivered within health plans, data scientists from Blue Health Intelligence® (BHI®) examined claims from more than 39 million eligible members. Of the … Read More

How BHI’s Population Advyzer Helped Three Health Plans Achieve Significant ROI in Risk Adjustment

BHIThought Leadership

Challenge Health plans today want greater internal control of their Affordable Care Act (ACA) and Medicare Advantage risk adjustment programs and increased visibility into the risk adjustment process. No longer content to rely on broad-brush chart reviews, provider engagement, and in-home assessments, health plans instead want greater accuracy, efficiency, and transparency in how members are selected and which interventions are … Read More

How to Build a Successful Big Data Analytics Program in Healthcare

BHIThought Leadership

Plan for big data

Most hospitals and health systems have started to collect some form of electronic information to help them with population health management, financial decision-making, or patient safety, but few have truly cracked the secret of using big data to generate measurable improvements in quality and revenue. Sanket Shah, Senior Director at Blue Health Intelligence, discusses how organizations struggle with big data … Read More

Fact or Fiction: Five Common Downfalls of Data Visualizations

Sanket ShahThought Leadership

Chart representation of data

Just like a photo can be altered to remove imperfections, visuals can be manipulated to support the narration an author wants to portray. Likewise, overly complicated visualizations can be just as deceptive. Thanks to technology, there is a wealth of data at our disposal. By falsely representing that data, we do a disservice to those that would benefit from its … Read More

5 Ways Your Health IT Startup Can Stay Ahead

BHIThought Leadership

Healthcare Startup

Entrepreneurs in the health information technology field are very aware that they have entered an industry full of competition and challenges. It calls for an extra level of due diligence among leaders in the field, who need to take extra care to not only keep up, but keep their businesses a few steps ahead of competitors. Sanket Shah, director at … Read More

Could a National Database Help the Opioid Crisis?

BHIThought Leadership

Lawmakers gathered with health care experts to determine what role data and technology can play in easing the opioid crisis that kills thousands of Americans every year. Some argued for a centralized database of national opioid prescriptions while Sanket Shah, director at BHI, went another way, suggesting that treatment duration was a better indicator of abuse and overdose than opioid … Read More

Five Best Apps to Boost Your Health

BHIThought Leadership

Mobile Health App

More than 165,000 healthcare applications have been developed for iPhones and androids — focusing on diet and fitness, as well as the management of heart disease, diabetes, cancer, and mental health. Millions use them to count steps, keep track of calories or remind them to take their medicine or supplements. How do you decide which ones are right for you? … Read More

Is Home-Based Medical-Data Collection About to Change Healthcare?

BHIThought Leadership

Home-based data collection

People are using smart phones, wearables and other home-based medical data collection devices to track their personal fitness and health. The market for this technology proves that people are willing to engage and interact in generating information that is critical to their health. More and more health organizations are realizing the potential of home-based data collection technology to generate better … Read More