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Heritage Provider Network In California Announces $3 Million Prize-Behavioral Analytics For Predictive Algorithmic Formulas On W

Posted Dec 06 2010 12:25pm

This is interesting as those who wish to participate will be given anonymized records of 100,000 patients who are current members of Heritage.  With using image analytic algorithms the goal is to predict a percentage of members who have been to the hospital and a percentage of those who will return.

It’s all about those algorithms and formulas to project cost.  This kind of reminds me of the Blue Cross failed X-Prize of a $10 Million offer of a couple years ago that quietly went away and as you can see by today’s technology $10 Million was not near enough nor was it possible.  One other thing to keep in mind too is that even though the data is anonymized, there are a couple of firms who have produced an algorithm to re-match this stuff and have applied for US patents so the availability of such software/algorithms in time may just completely knock the socks off of the advertised non identified data bases.  Of course it can be done manually with writing SQL statements as when I was writing code I did that stuff all the time when presented with a problem and needing to combine data bases with a unique identifier code, it’s part of the business of writing software and all programmers do that, but perhaps not for the same reasons.  Here’s an example of a company that has applied for the patent to match via social networks as an example. 

New York-based PeekYou LLC has applied for a patent for a method that, among other things, matches people's real names to the pseudonyms they use on blogs, Twitter and other social networks. PeekYou's people-search website offers records of about 250 million people, primarily in the U.S. and Canada.  Granted this article states that the parties will be given this information but if email addresses or other such items are used, well then through the use of additional software it could go out and search and mine the social networks to add even more information.  Here’s a related story on how one site was mined and how the data was sold. 

This is where all the real big spending comes in health care, the pursuit of the analytic algorithms to find those “earmarked” patients who are going to end up costing money with those illnesses we all have as humans and as you can see with the offering here of $3 Million the data and research numbers hold value to insurance companies so they can cut costs and payouts, as Wendell Potter stated that on Wall Street and in other investment areas claims paid are seen as a loss.

It’s too bad that all the focus is on the patient/doctor side and not enough effort is made to reduce the cost of drugs and devices as those are fixed costs that certainly are up for negotiation and the doctors are only the vehicles to provide that care for patients who need it and with further private equity investments this is where the dollar seems to be rising above patient care, a sad reality.  This announcement was made according to the press release in conjunction with former HHS Director, Mike Leavitt who is on the board of a healthcare financial services company. 

Again, it’s all about those financial algorithms and cutting cost in healthcare and if you read the news, it’s all over the place so again be careful on what web based services you use and what information you place out there as data mining and predictive behavioral health analytics is all over the place.  In recent posts here I have also blogged about how the pharmacists at Walgreens are on pay for performance to use the United/Ingenix algorithms to predict behaviors as well, so again everywhere you turn today someone wants to analyze you and your data and whether or not these predictive business models produce the algorithmic desired results remains yet to be seen.  BD

WASHINGTON--( BUSINESS WIRE )--Heritage Provider Network (HPN), an award-winning managed care organization with a focus on the physician-patient relationship, today announced a $3 million competition designed to develop a more accurate way to predict the likelihood of an individual’s future hospitalization, thus allowing physicians to target care and avoid unnecessary hospitalizations.

“Ultimately, this prize will help solve a critical issue facing our country: health care spending,” said HPN President and CEO Richard Merkin, M.D. “It will help make health care more affordable and help to achieve the goals of health care reform. We spend more than $30 billion a year in unnecessary hospital admissions. If private industry can help solve that part of the problem, we can begin to move from a sick care system to a true health care system.”

Dr. Merkin announced the prize at a news conference today in Washington, D.C., joined by former Health and Human Services Secretary Michael O. Leavitt. “We need innovative thinking to solve one of the biggest dilemmas of our time – ever-rising health care costs. The Health Prize is an example of what the private sector is willing to do to encourage that type of thinking,” Leavitt said.

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