Data Mining Moves Insurers Forward

Although predictive technology can better forecast who will need healthcare, health plans fall short in clinical interventions because their medical management is fragmented and inefficient and they lack economic incentives for doctors to participate, concludes a research brief from Forrester Research Inc., Cambridge, Mass. Health plans should invest in data mining, nonetheless, the brief states, because predictive models help them to refine pricing, improve quality and manage cash flow. To make the most of the data they have, Forrester advises insurers to select a knowledge engineering partner such as Ingenix, MEDai, iMcKesson and CareSteps, which offer data mining and analysis. In addition, plans should coordinate data cleanup and integration with HIPPA compliance. Forrester also suggests that insurers pilot Internet-enabled care management technologies to improve access to real-time patient information, automate workflow and track adherence to best practice guidelines.