Dive Brief:
- Independence Blue Cross is using a computer algorithm to identify customers headed toward likely hospitalization. The program analyzes health data and calculates a score for each patient.
- The company assigns a "health coach" to each high scorer, who works to coordinate care and services—simultaneously assisting the patient and reducing costs. The company says it has identified 18,000 customers for assistance and that through successful intervention, it has achieved a 40% to 50% drop in its expected hospital admission rates for congestive heart failure patients.
- The program has faced privacy questions; the company says it follows federal guidelines for anonymity—but it offers no choice to opt in or out of the service.
Dive Insight:
The company's algorithms examine health data ranging from billing claims to lab readings, medications, family history, and geographic information including poverty rates.
"The healthcare data we provided to build these algorithms is equivalent, I think, to five Wikipedias," Independence Blue Cross CIO Somes Nigam told NPR. The company is so pleased with its early results that it is planning to target Type 2 diabetes next by working with those at highest risk of developing it in order to prevent it.