Blue Cross Intelligence Buys Intelimedix, A Company That Specializes in Serving Employers and Health Insurers, More Analytic Alg
Posted Jan 09 2013 3:38pm
In reading the website and other items on the web it appears the latest efforts here were focusing on building a solution for Blue Cross Intelligence so guess who bought them. Recently it was announced that the firm that manages the Blue Cross venture was moving to San Francisco to start up an incubator so is this a sign of perhaps where some of the funding may have come from? Despite showing promise, Blue Health Intelligence has proven to be a costly endeavor, with $31 million in revenue and $43.6 million in expenses in 2010.
Remember a while back where I said start ups and accelerators are a good place for insurers to shop for cheap code , well Blue Cross has their start up area where start ups can get started writing that “cheap code”. Intelimedix is a bit more than that though and has been around for abut 7 or 8 years but when you read their history, it’s been a long engagement with Blue Cross to even hiring their current CEO from there.
Everyone runs their business intelligence today to maximize profits and perhaps this is the winning addition for Blue Cross Intelligence. One day down the road as more of these auditing 3rd parties arise, are we going to see a DOS (denial of service) with the IT pipelines being over run with 3rd party bots to analyze (grin) and end up with “claim stuffing as this type of business with promising the best algorithms ”:) Who’s going to start selling that one with “speed” emphasized just the markets do? You know it will happen as this evolves as that will be a marketing point when all have their auditing algorithms at equal levels. BD
From the website: ”With locations in the U.S. and Europe, Intelimedix offers off-the-shelf analytic and data mining applications as well as customized solutions. In addition, Intelimedix has developed solutions specifically for Blue Health Intelligence (BHI®), a national data warehouse developed by participating Blue Cross Blue Shield Plans to share critical health information with employers, consumers and providers. From our strategic partnership with a consortium of Blue Cross and Blue Shield licensees, and broad healthcare experience, we leverage our unique collaborative position to deliver solutions that have immediate impact on and bring savings to your organization.”
Blue Health Intelligence, the database/analytics services division of the Blue Cross and Blue Shield Association, has acquired analytics vendor Intelimedix for an undisclosed sum.
BHI’s database holds medical and pharmacy claims data from more than 110 million individuals to identify ways to raise quality standards and manage costs. The database has enough information to reflect medical utilization in every ZIP code in the nation, according to the company.
Tampa, Fla.-based Intelimedix specializes in serving employers and health insurers, supporting analysis of such issues as unnecessary care, fraudulent and abusive billing, overpayments from billing and coding errors, pharmacy fraud, and preventable conditions. Combining the technologies will enable expansion of analysis on a range of issues to help clients manage financial and medical risk, according to the vendors.