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
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
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
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
Using Visual Analytics, Big Data Dashboards for Healthcare Insights
Healthcare organizations’ thirst for insights has intensified over the past few years. Executives want to be able to use data to figure out why something is happening, what to do about it, and what to expect in the future. BHI’s Sanket Shah contributes to this article about how there is a lot of data and why getting actionable insights from … Read More
Fact or Fiction: Five Common Downfalls of Data Visualizations
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
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?
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
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?
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