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Office of Personnel Management Data Base Wants to Learn How to Create Those Cost Savings Algorithms Too-Analyzing Government Emp

Posted Dec 06 2010 2:28pm

Actually this is a good thing for the government to try and enter the analytics picture that is hugely dominated by insurance companies and of course those added in private equity firms.  The key here again is privacy and from what we are seeing out there on the web today it is a total crap shoot so why now allow the government an opportunity to learn up and figure out their own cost savings formulas as we will hopefully end up with algorithms for accurate results and not those of “desired’ results as seen through the carriers.  We don’t get to see those anyway and it’s like Forest Gump insurance and claims today in the fact that you never know what you are going to get. 

The only way to get a feel for what is going on in private industry is to work and develop your own set of algorithms and we all know there are companies out there that will re-match anonymized data. 

Former HHS Director Leavitt is ready to cash in on some of this activity so why not let the government get smarter and take some of the profits off Wall Street?   This is actually very cool as the government can analyze around 230 private health care plans and see it from the bottom up.  Fat chance on getting the insurance companies to analyze their own data for accurate results as they all tend to lean more toward the “desired” results category as they have stock holders to report to and every claim filed is seen as a loss.  The Office of Personnel Management might as well forget that request and go about their work with being impartial for a somewhat accurate prospective reporting system.  It’s a joke to ask for profit health insurers to contribute information that is not in their best benefit to profit. 

They already dig through Tri-Care and other government healthcare plans that make a profit as they are run by either direct insurance companies or their subsidiaries.  This organization put out a notice today to pay $3 Million for similar analytics relating to behavior. 

ONCE MORE IT’S ALL ABOUT THOSE ALGORITHMS FOR DECISION MAKING PROCESSES AND WE DO WANT ACCURATE ALGO VERSUS THE ALGOS CREATED FOR DESIRED RESULTS OR WHAT COULD BE CALLED ROGUE ALGOS.  BD

An Office of Personnel Management plan to launch a comprehensive database of federal workers' health care records has raised the ire of some privacy advocates, employee unions and consumer groups.

OPM is organizing a research database of insurance claims filed by the eight million workers and dependents enrolled in the Federal Employees Health Benefits Program, as well as participants in two other federally administered programs. The claims data, which will be supplied by the private insurers that participate in the FEHBP, will help OPM figure out ways to lower costs, improve quality and fight fraud, the agency has said.

In addition, the OPM official said asking insurance companies to independently analyze their own data would defeat a key purpose of the database - which is to compare health plans. For example, one health plan might charge more than another for prescription drug programs and the data might help OPM decide whether to drop one pharmacy benefits manager in favor of another. About 30 percent of FEHBP's spending goes for prescription drugs.

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