The number of individuals with high-cost and very high-cost medical claims is continuing to grow, consuming more and more of the total healthcare spend in the United States. The ability to predict which individuals are on a path to high cost, and which interventions have the best chance of preventing that eventuality, has become critically important.

Almost $1 of every $3 spent in healthcare is wasted on services that have little or no clinical benefit, are potentially harmful, or are delivered in unnecessary high-cost settings. The potential to harm patients may stem directly from the risks of LVC, or indirectly from additional tests and procedures that contain risks and/or have little or no clinical benefit. Blue … Read More

Research from Blue Health Intelligence® (BHI®) shows that for the last two years, pharmacy (Rx) spending has contributed more than inpatient hospital costs to the total cost of care (TCOC) for commercially insured Americans.

Swati Abbott, CEO of Blue Health Intelligence, firmly believes her company can help reduce waste through the use of artificial intelligence and expert analytics. Blue Health Intelligence is a privately held healthcare analytics and intelligence company with access to the largest, most current health care data repository in the US.  It leverages data insights into innovative analytics solutions. BHI has proven … Read More

Though the majority of the healthcare industry recognizes the impact social determinants have on overall health, collecting this data has proved challenging. Providers often feel that they don’t have the time or the resources to gather and capture this data, which can keep them from addressing the barriers that affect their patient populations. Shah discusses what some organizations are advising to help … Read More

The collaboration showcased in the Analytics and Informatics sessions at this year’s Blue Cross Blue Shield National Summit was amazing. It was impressive to see how BHI and the Blue Plans are working to assure that AI, machine learning, data analytics, and predictive modeling are being combined with real-world knowledge to produce meaningful solutions for payers, members, and providers. Attendees … Read More

Predicting when and where disease will occur would be of great assistance to medical professionals and public health officials, who could more aggressively focus public awareness campaigns and other programs on certain populations to inhibit the development and spread of measles, or other potentially deadly viruses. In fact, the World Health Organization’s risk assessment tool has been successfully used to … Read More

There is a tremendous opportunity for VR (virtual reality) and AR (augmented reality) solutions to help healthcare providers unlock the value of vast amounts of health data that have never been used to their full potential. By leveraging this trove of information, organizations will have opportunities to significantly reduce costs and provide higher-quality patient care. Technology companies are racing to … Read More