Blue Health Intelligence’s Risk Adjustment and Stratification Solution Goes Live at Highmark Inc.

In News by BHI

Population Advyzer will help close healthcare gaps for the large national insurer

CHICAGO (September 11, 2018) – Blue Health Intelligence® (BHI®), a leader in the healthcare data and analytics space, is partnering with Highmark® to provide risk adjustment informatics for Highmark’s Medicare Advantage (MA) and Affordable Care Act (ACA) populations. Together, BHI and Highmark are working to better capture members’ health conditions and close coding and care gaps.

In early August 2018, Highmark began using Population Advyzer to generate advanced analytics. This information will further refine the plan’s ability to target the right gap-closure activities for the right members and providers, and reduce unnecessary and wasteful interventions. The result will be reimbursement that better reflects the actual health status of Highmark’s populations.

“By partnering with BHI, we are accelerating our program objectives to deliver higher-quality care at a lower price by using more accurate and transparent analytics,” said Deborah Rice-Johnson, president, Highmark Health Plan. “BHI and Highmark share a commitment to continually measure program performance to inform improvement opportunities.”

“In working with Highmark, we are using a range of best practices gained from BHI’s successful collaboration with other health plans,” said Swati Abbott, CEO of BHI. “Together, we are building more informed, efficient, and effective ACA and MA risk-adjustment informatics, and supporting Highmark’s ability to accurately share care and coding gap information with relevant providers.”

BHI’s Population Advyzer platform applies advanced analytics, predictive models, machine learning, and clinical logic to uncover the most impactful opportunities for accurately measuring members’ healthcare status. The flexible platform is easily integrated into health plans’ workflows for all care-gap-closing programs. Population Advyzer also allows for multiple provider attribution when it’s appropriate to engage both primary care and specialists in a member’s healthcare. The platform also aggregates reporting analytics for different health plan and provider arrangements, including accountable care organizations, health systems, provider groups, and individual providers.

About Highmark Inc.

Highmark Inc. and its health insurance subsidiaries and affiliates collectively are one of America’s largest health insurance organizations and together with its Blue-branded affiliates, collectively comprise the third-largest overall Blue Cross and Blue Shield-affiliated organization in the country based on capital.

Highmark Inc. and its affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve approximately 4.6 million members and hundreds of thousands of additional individuals through the BlueCard® program. Its diversified businesses serve group customer and individual needs across the United States through dental insurance, vision care and other related businesses. Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit

About Blue Health Intelligence®

Leveraging the power of medical and pharmacy claims data from more than 180 million Americans, Blue Health Intelligence (BHI) delivers insights that empower healthcare organizations to improve patient care, reduce costs, and optimize performance. With the largest, most up-to-date, and uniform data set in healthcare, BHI provides an accurate representation of the health profile of commercially insured Americans. Our team of data analysts, clinicians, IT experts, and epidemiologists provide analytics, software as a service, and in-depth consulting to payors, providers, employers, medical device companies, and other healthcare stakeholders. Blue Health Intelligence is an independent licensee of the Blue Cross Blue Shield Association and carries the trade name of Health Intelligence Company, LLC. For more information, visit

To learn more about BHI’s capabilities, contact:

Erikt Blaess
(312) 540-5196