An important trend in healthcare is the use of big data to predict the future. Imagine getting a phone call from a doctor who knows, thanks to advance analytics from your health insurance company, that you may be likely to end up in the hospital in the next six months.
Now imagine that call leading to proactive care and support that helps improve your health and ultimately avoids a stressful and costly trip to the hospital, along with time away from family.
It’s a reality at Blue Cross and Blue Shield of Louisiana (BCBS Louisiana), where they launched the Data Excellence program in 2017. The program uses member data – like claims, medical records, prescriptions and more - to create predictive models that determine who is at risk for hospitalization, emergency department visits and/or readmission.
The information allows BCBS Louisiana the ability to proactively engage with members by connecting them to in-house medical teams consisting of nurses, dieticians and social workers. BCBS Louisiana also provides the information to members’ doctors, so they know the full picture of their patients’ health, including the healthcare events that happen outside of that doctor’s office.
This innovation in healthcare is leading to improved health for members in Louisiana. Among its highest risk population, the hospitalization model identifies close to 50% of those who will have a hospitalization in the next six months. BCBS Louisiana also reports a high engagement rate of 70-80% of these members that are targeted for care coordination, health coaching and education. (Normal engagement rate is 20-30%.)
In this video, learn how the BCBS Louisiana analytics and data teams can help members before they get sick using clues from medical records and insurance claims. You can also watch more videos about innovative ways BCBS Louisiana is using data to help improve the health of its members.
Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.