Healthcare cost information will soon be accessible to everyone across the healthcare ecosystem. Finalized by the Departments of Health and Human Services, Labor, and the Treasury on November 12, 2020, the Transparency in Coverage rule puts healthcare price information in the hands of consumers, providers, and health plans to empower stakeholders with the information they need to make informed healthcare …
Informing Medical Device Strategies with Real-World Data
Real-world health data plays a significant role in guiding the strategies and innovations of medical device manufacturers. Whether they are looking to develop commercialization strategies, gain regulatory approval, or demonstrate the value of their products, these manufacturers can use real-world data (RWD) and real-world evidence (RWE) to inform product development and assess their products’ potential value. Ultimately, developing new medical …
COVID-19 Challenges Continue: How Plans Can Now Track the At-Home Test Benefit
As of January 15, 2022, U.S. insurance companies and health plans are required to cover eight free over-the-counter, at-home COVID-19 tests per covered member per month. As with so many other aspects of this pandemic, payers were forced to pivot and respond quickly. Now they must provide government-mandated coverage and track and forecast their finances to manage their businesses prudently. …
National Healthcare Benchmarks are Broadening Employer Groups’ Perspective on COVID-19
One of the biggest challenges employer groups have faced during COVID-19 is a lack of perspective on the overall cost and utilization of their employees’ COVID-19 testing and treatment. They have employee claims data – and maybe their health plan’s data to compare against – but they don’t know how they compare more broadly. In response, health plans have been …
In Their Quest for Health Equity, Some Insurers Emphasize Mothers and Babies
If we look back on 2020 as the year that thrust racial inequities into the national consciousness, 2021 may be the year we see the tide start to turn. We’re starting to see efforts to address health equity progress across the healthcare ecosystem. Anthem, the largest of the Blue Cross Blue Shield affiliates, announced in August the creation of a …
Whyzen™ Analytics’ Latest Release Provides Faster Pathways to Healthcare Intelligence
By Sonal Sheth, Senior Director, Product Manager, Whyzen Analytics, and Kelvin Evans, Sales Executive BHI’s enhanced Whyzen™ Analytics platform enables health plans, employers, and brokers to quickly find and act on trends, cost savings, and care improvement opportunities. New guided analytics pathways and a more intuitive interface allow this next-generation reporting and analytics solution to sort through vast healthcare data …
Artificial Intelligence Saves Payers Time, Money
BHI’s Roxanna Cross was recently interviewed by Managed Healthcare Executive® magazine on the topic of AI, machine learning, and health insurance. The premise was simple: AI can save health plans money while improving care delivery and outcomes. An excerpt follows: “At Blue Health Intelligence (BHI), which provides clinical data expertise for Blues plans around the United States, programmers attacked the …
From Coronavirus Pandemic to Mental Health Epidemic
How employers are handling the mental health challenges of employees in the wake of COVID-19 The public health response to the COVID-19 pandemic may have saved millions from dying of the SARS-CoV-2 pathogen. But, according to researchers, the lockdowns, social distancing, and masking also had a significant impact on people’s mental health. COVID-19 was particularly hard on young adults and …
Health Plans Required to Provide Price Comparison Tool by January 2022
At the end of 2020, Congress passed the Consolidated Appropriations Act (CAA) which includes a number of key provisions for health plans. Among them is the requirement that health plans offer a web-based price transparency tool that will communicate expected costs of various services provided in a health plan member’s service area. The tool must provide out-of-pocket costs for these …
Telehealth Use Spikes Amongst Commercially Insured Individuals During the Pandemic, but a Digital Divide Remains
BHI co-authored a recently published study in JAMA Network Open that found almost 24% of privately insured working-age individuals used telehealth for outpatient care in the early phase of the pandemic compared to just 0.3% during the same time in 2019. However, persons living in areas with limited social resources were significantly less likely to use telehealth, suggesting barriers to …
Big data used on a small scale can yield impressive results
Benchmarking data from Blue Health Intelligence® (BHI®) provided independent verification that the Spine Team Texas (STT) approach to treating low back pain resulted in lower costs for insurers and employers.
Analytics-based reporting solution takes the fast track to deployment
Undeterred by a tight development schedule, complex user needs, and a pandemic that brought shutdowns and remote work, Blue Cross Blue Shield of Michigan and BHI’s Whyzen Analytics team successfully replaced a legacy data reporting platform for Blue Cross’ agents, brokers, and consultants in just four months. The new analytics-driven solution, Scheduler for Agent Reporting, or SAR, benefited from the …
BHI claims data is helping Concert Genetics connect a much-needed genetic health information network
Combining its genomic data with de-identified claims data from BHI has helped Concert Genetics shine a bright light on unnecessary coding variations and price disparities in the genetic health information network. The demand for genetic testing is dynamic and difficult for payers to discern. Using the BHI claims data along with their own data, Concert Genetics watches trends and helps …
How Population Advyzer helped three health plans achieve significant ROI in risk adjustment
Population Advyzer was employed by three health plans to help improve their risk score accuracy and ensure reimbursement reflected the actual risks within their ACA and MA populations. Using the advanced analytics, predictive models, machine learning, and clinical logic within Population Advyzer, plans were able to uncover the most impactful opportunities to resolve coding discrepancies, close care gaps, and maximize …
Best-in-class data, combined with machine learning, provides revolutionary insight into chronic disease management
Rich claims data from Blue Health Intelligence® (BHI®) made it possible for Decode Health to create comprehensive models that detect patients with undiagnosed or misdiagnosed disease and predict individuals who will likely experience the highest healthcare spend.
Data supports therapy provider’s claims of lower costs, higher quality
Airrosti wanted to expand outside of Texas and instill a culture of continuous improvement. To meet their objectives, Airrosti leaders utilized data and analytics to improve their care model, manage their providers, and further prove their worth to payers and employer groups. Data from Blue Health Intelligence helped Airrosti show that their methods reduced the total cost of care, limited …
Blue Health Intelligence Names Sam Mohanty as Chief Technology Officer
Data Expert to Develop Next-Generation Analytics Platforms for Customers CHICAGO (Nov. 2, 2022) — Blue Health Intelligence® (BHI®) – a leading healthcare data and analytics firm – appointed pharmacy benefit management veteran Sam Mohanty as Senior Vice President and Chief Technology Officer. Mohanty will oversee BHI’s IT and data engineering functions that support the company’s expanded customer solutions. Mohanty brings …
Blue Health Intelligence Names Matt Siegel as Chief Growth Officer
Seasoned Healthcare Leader Will Help Define BHI’s Vision for Customer Success and Value Realization CHICAGO — Blue Health Intelligence® (BHI®) – a leading healthcare data and analytics firm – has appointed Matt Siegel as Chief Growth Officer. He will be responsible for creating high-value customer experiences, building a culture of client-centric delivery and execution, and driving the next phase of BHI’s …
Blue Health Intelligence Names Divya Srungaram to Spearhead Product Management
Global Healthcare Executive to Push Development of Innovative Products That Improve Outcomes, Lower Costs CHICAGO (Sept. 29, 2022) — Blue Health Intelligence® (BHI®) – a leading healthcare data and analytics firm – has appointed Divya Srungaram as Vice President, Product Management. Srungaram will oversee all aspects of developing and commercializing BHI’s innovative national account and employer products and position the …
Blue Health Intelligence Names Chris Birkmeyer to Lead Product Strategy
Veteran Operational Leader to Guide Development of Transformational SaaS and DaaS Products CHICAGO (August 24, 2022) – Blue Health Intelligence® (BHI®), a leading healthcare data and analytics firm, has appointed Chris Birkmeyer, MS, as Senior Vice President of Product Strategy. Birkmeyer will lead BHI’s strategic product roadmap and expand and strengthen the company’s broad portfolio of analytic products and services. A proven …
Blue Health Intelligence Appoints Bob Darin as CEO
CHICAGO (July 28, 2022) – Blue Health Intelligence® (BHI®), a leading healthcare data and analytics firm, announced today that Bob Darin has been appointed Chief Executive Officer, effective July 22. Darin has served as interim CEO since March 2022, leading the company’s growth strategy, and accelerating BHI’s work to further leverage the industry’s most comprehensive and trusted data and analytic …
BHI’s Qualified Entity Report Confirms Health Inequities Contribute to Diabetes-Related Admissions
CHICAGO (January 25, 2022) –In its first report as a certified Medicare Qualified Entity (QE), Blue Health Intelligence® (BHI®) examines the relationships among preventable diabetes, hypertension admission rates and socioeconomic status (SES) measures to deliver preventive care to reduce avoidable hospitalization. The report’s findings reinforce the profound impact that social determinants of health (SDOH), including SES, have on health outcomes. …
Blue Health Intelligence Achieves HITRUST CSF® Certification to Manage Risk, Improve Security Posture, and Meet Compliance Requirements
CHICAGO (January 20, 2022) – Blue Health Intelligence® (BHI®), a leading provider of healthcare data analytics, today announced its Whyzen™ Analytics employer reporting platform, Population Advyzer risk adjustment solution, and its Common Data Platform have earned Certified status for information security by HITRUST. HITRUST CSF Certified status demonstrates that the organization’s three technologies have met key regulations and industry-defined requirements …
Blue Health Intelligence’s Benchmarking Solutions Offer Tailored and Comprehensive Views of Healthcare Performance
CHICAGO (November 3, 2021) – Healthcare stakeholders that are seeking to improve competitiveness, reduce costs, and close performance gaps can take advantage of two benchmarking resources developed by Blue Health Intelligence® (BHI®): the Whyzen™ National Benchmark Module (NBM) and the Customized Benchmarking Data solution. The NBM is an easy-to-use, standalone application that allows clients to visualize and analyze cost, quality, …
Blue Health Intelligence Releases Enhanced Whyzen™ Analytics Platform
Analytics Tool Drives Users to Most Valuable Healthcare Insights CHICAGO (October 12, 2021) – Blue Health Intelligence® (BHI®) recently infused guided analytic pathways and a more intuitive interface into its cutting-edge employer analytics and reporting solution, Whyzen™ Analytics, to enable healthcare stakeholders to quickly sort through vast healthcare data and identify key cost savings and care improvement opportunities. “These updates …
Prognos Health and Blue Health Intelligence® Partner to Improve Accuracy of Underwriting Decisions for the Group Risk Market
Combined offering enables health plans to quote with more accuracy to win the right business at the most optimal rates. NEW YORK (July 21, 2021) — Prognos Health and Blue Health Intelligence® (BHI®), two of the nation’s leading healthcare data analytics companies, have partnered with a multi-year agreement that combines Prognos’ lab data registry of 325 million de-identified lives comprised …
“Delay to TKA in Patients Treated with a Multimodal Approach using High Molecular Weight, Biologically Derived Hyaluronic Acid”
The Journal of Long-Term Effects of Medical Implants, March 2021 The primary objective of this study was to determine the effect of single versus multiple rounds of intra-articular hyaluronic acid (IA-HA) in delaying the need for total knee arthroplasty (TKA) in patients with knee OA, and if additional benefits were seen when used in conjunction with other multimodal treatment options. Methods …
“In-Person and Telehealth Ambulatory Contacts and Costs in a Large U.S. Insured Cohort Before and During the COVID-19 Pandemic”
JAMA Network Open, March 2021 BHI co-authored a study in the JAMA Network Open that found almost 24% of privately insured working-age individuals used telehealth for outpatient care in the early phase of the pandemic compared to just 0.3% during the same time in 2019.
“Delay to TKA and Costs Associated with Knee Osteoarthritis Care Using Intra-Articular Hyaluronic Acid: Analysis of an Administrative Database”
Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, March 2021 The primary objective of this study was to examine the relationship between intra-articular hyaluronic acid (IA-HA) treatment and delaying TKA in patients with KOA compared to patients not receiving IA-HA, as well as to identify differences in KOA-related costs incurred among patients who received or did not receive IA-HA.
“Knee OA cost comparison for hyaluronic acid and knee arthroplasty”
Journal of Orthopaedic Surgery and Research, August 2020 Limiting treatment to those recommended by the American Academy of Orthopaedic Surgeon Clinical Practice Guidelines has been suggested to decrease costs by 45% in the year prior to total knee arthroplasty, but this only focuses on expenditures leading up to, but not including, the surgery and not the entire episode of care. BHI’s …
“Medical Utilization Surrounding Initial Opioid-Related Diagnoses by Coding Method”
The American Journal of Managed Care, February 2020 A budget impact analysis was conducted from a U.S. commercial payer perspective over a 1-year time horizon with patients who received the implant or revision ESS. Primary outcomes of interest were annual total and per-member per-month (PMPM) direct health care costs. Costs were estimated using a decision analysis model, assuming 50% implant …
“Lymphedema-associated comorbidities and treatment gap”
Journal of Vascular Surgery: Venous and Lymphatic Disorders, September 2019 To determine the proportion of LE patients with various LE-associated comorbidities as well as the rate of associated treatment, deidentified Health Insurance Portability and Accountability Act-compliant commercial administrative claims from the Blue Health Intelligence® (BHI®) research database (165 million Blue Cross Blue Shield members) were queried. We analyzed a BHI …
“Budget Impact of a Steroid-Eluting Sinus Implant Versus Sinus Surgery for Adult Chronic Sinusitis Patients with Nasal Polyps”
Journal of Managed Care & Specialty Pharmacy, August 2019 A budget impact analysis was conducted from a U.S. commercial payer perspective over a 1-year time horizon with patients who received the implant or revision ESS. Primary outcomes of interest were annual total and per-member per-month (PMPM) direct health care costs. Costs were estimated using a decision analysis model, assuming 50% …
“The Influence of Physician Payments on the Method of Breast Reconstruction”
Journal of the American Society of Plastic Surgeons, October 2018 Using the Blue Health Intelligence® database from 2009 to 2013, patients were identified who underwent tissue expander (i.e., implant) or free-flap breast reconstruction. The implant-to-flap ratio and physician payments were assessed using quadratic modeling. Matched bootstrapped samples from the early and late periods generated probability distributions, approximating the odds of …
“Budget Impact of Increased Payer Adoption of the Flexitouch Advanced Pneumatic Compression Device in Lymphedema Patients”
Journal of Medical Economics, July 2018 Budget impact was calculated over 2 years for a hypothetical US payer with 10-million commercial members. Model inputs were derived from published sources and from a case-matched analysis of Blue Health Intelligence® (BHI®) claims data for the years 2012-2016.
“Benefits of Advanced Pneumatic Compression Devices in Patients with Phlebolymphedema”
Journal of Vascular Surgery, June 2018 This was a longitudinal matched case-control analysis of deidentified private insurance claims. The study used administrative claims data from Blue Health Intelligence® for the complete years 2012 through 2016. Patients were continuously enrolled for at least 18 months, diagnosed with phlebolymphedema, and received at least one claim for CONS either alone or in addition …
BHI’s Qualified Entity Report Confirms Health Inequities Drive Diabetes-Related Admissions
As a certified Medicare Qualified Entity (QE), Blue Health Intelligence® (BHI®) produces a publicly available report assessing national quality measures using data from Medicare and Blue Cross Blue Shield commercial claims data. In this report, we examine the relationships between preventable diabetes and hypertension admission rates and socioeconomic status (SES) measures to inform the potential of improved access to preventive …
Transparency Analytics FAQ
Get the answers to the most frequently asked questions about the Transparency in Coverage rule, machine-readable files, and our Transparency Analytics solution.
QE Report 2021: Examining the relationship between socioeconomic factors and preventable diabetes- and hypertension-related inpatient admissions
As a certified national Qualified Entity (QE), BHI combines Medicare fee-for-service data with our own rich set of commercial claims data from more than 234 million individuals to research and report on the quality and delivery of care in the U.S. Our first QE report focuses on diabetes due to its increasing prevalence and ability to be effectively managed if …
Q&A: Enhanced Release of Whyzen Analytics Uses Guided Pathways to Highlight Key Findings
Kevin O’Mara, Vice President, Product Management, and Michele Heeter, Senior Director, Product Learning and Communication, discuss how BHI has reimagined Whyzen Analytics, our employer analytics and reporting solution, to help users identify and address healthcare cost, utilization, quality, and risk concerns before they escalate.
Blue Health Intelligence Offers Comprehensive Benchmarking Solutions
The November 2021 issue of Care Analytic News profiled two benchmarking resources from Blue Health Intelligence® (BHI®): the Whyzen™ National Benchmark Module (NBM) and the Customized Benchmarking Data solution.
Enhanced Whyzen™ Analytics Platform Drives Users to Most Valuable Insights
Care Analytic News showcased enhancements that Blue Health Intelligence® made to its Whyzen™ Analytics platform. The article highlights how new analytic pathways and a more intuitive interface are guiding healthcare stakeholders directly to key cost savings and care improvement opportunities.
Q&A: National Benchmarking Module Unlocks Insights Into Healthcare Costs and Utilization
In our latest Q&A, Carolyn Jevit, senior product director, discusses how BHI’s National Benchmarking Module (NBM) uses data to provide health plans and their employer customers with a deeper understanding of cost and utilization improvement opportunities at national, regional, plan, and account levels.
Q&A: The Importance of REL Data in Achieving Health Equity
Almost all commercial health plans are seeking to address health disparities, but few have the reliable and widespread race, ethnicity, and language (REL) data needed. Learn how, in the absence of self-reported data, Plans can continue to make progress.
Study: Telehealth Consults Increased Over 50-Fold During First Phase of Pandemic
An article in Care Analytic News discusses the findings from a recent study co-authored by researchers at the Johns Hopkins Bloomberg School of Public Health and Blue Health Intelligence®. The study found that telehealth consults among privately insured working-age patients accounted for almost 24 percent of outpatient consults with health care providers during the early phase of the pandemic, March …
Using BHI data to assess the impact of COVID-19 on telehealth utilization
The explosive growth of telehealth has been discussed extensively in the past year. To provide even greater insights into the nature of this COVID-19 driven-trend, BHI studied our conformed national medical claims data set, comprised of more than 22 billion claims that represent 217 million unique lives, to unearth different telehealth insights.
Whyzen Analytics Boost Your Skills
In this session, the Whyzen® Analytics’ product development team focuses on: Auto-sync – Making sheets available across all accounts; Variance table extension – Comparing data to benchmarks and identifying strengths and opportunities; New dashboards – Displaying maternity content, pharmacy analysis, networks/HPNs, and more; and Container charts – Use them to combine separate visualizations and maximize sheet design.
Whyzen Analytics Boost Your Skills
The Blue Health Intelligence® team demonstrates select features of Whyzen® Analytics, our account analytics and reporting solution. This webinar includes tutorials on: Ranking measures within a table: Rank providers and members by various measures. We also show you how to use custom expressions for ranking. Building statistical charts: We focus on box plots to display data sets along with standard …
Whyzen Analytics Boost Your Skills
The Blue Health Intelligence® team demonstrates select features of Whyzen® Analytics, our account analytics and reporting solution. This webinar includes tutorials on: The new COVID-19 at-home test cost modeler: See how Whyzen Analytics can help you project costs for this new benefit The enhanced release of Whyzen Analytics: Get a refresher on the new features and satellite sheets that are …
Whyzen™ Analytics Boost Your Skills
The Blue Health Intelligence® team demonstrates select features of Whyzen™ Analytics, our account analytics and reporting solution for health plans, employers, and brokers. This webinar includes tutorials on: Selection Criteria – The ability to import and integrate user-generated data into analyses Color Palettes – A broader set of design options that lets you customize reports, dashboards, and KPIs COVID-19 Reporting …
Whyzen™ Analytics Boost Your Skills
In this session, the Whyzen™ Analytics’ product development team focuses on: the new landing Page – a continuation of the tour through the new dashboard and satellite sheets; data visualization – how to create grid charts; and enhancements to community features, an outstanding collaboration tool for teams of healthcare data analysts.
Whyzen Analytics Boost Your Skills
The Blue Health Intelligence® team demonstrates select features of Whyzen Analytics, our account analytics and reporting solution for health plans, employers, and brokers. This webinar includes tutorials on: Whyzen’s New Landing Page: A reimagined dashboard and several useful access points to the most important data Data Visualizations: Gauge Charts, Quadrant Charts Storytelling: A great way to walk your audience through …
A Better Crystal Ball: Predictive Analytics for Member Risk
In this webinar, BHI experts Roxanna Cross, AVP of product management, and Russ Robbins, AVP of clinical informatics share: How to avoid the pitfalls of biased predictions using an equity adjusted model How using an ensemble of predictive models creates an impactful clinical narrative The role of SDOH factors in painting a holistic picture of individual members Sample BHI Member …
Whyzen Boost Your Skills
The Blue Health Intelligence® team demonstrates how to use the many features of Whyzen Analytics, our account analytics and reporting solution for health plans, employers, and brokers. This webinar’s deeper dives include tutorials on: Custom Communities Enhancements: More Easily Sharing Analyses with Authorized Users Design Mode: A Faster Way to Edit Chart Objects Graphics Features of the New Release of …
Whyzen Boost Your Skills
The Blue Health Intelligence® team provides demonstrations of current and upcoming features of Whyzen Analytics, our account analytics and reporting solution for health plans, employers, and brokers. This month’s focus is on Graphics and Data Visualization. This recording’s deeper dives include tutorials on: Fundamentals of Data Visualization Applying the Fundamentals in Whyzen: Combo charts, stacked bar charts, treemap charts, and …
Insights from BHI: Intersection of Behavioral Health & Chronic Medical Conditions
In this webinar, Joe Bisson, vice president of business development, and Farid Alam, MD, director of clinical analytics with BHI provided unique analysis of chronic conditions such as diabetes, heart disease, asthma, and mental health, illustrating how BHI’s closed claims dataset highlights the challenges that chronic conditions pose to the healthcare system. Chronic conditions account for over $3.5 trillion of …