Earlier this month, the national Blue Cross and Blue
Shield Association announced an initiative to compile claims
information from 79 million patients into a database that can be shared with 20
participating Blue Cross plans.
The Blue Health Intelligence (BHI) project, which was unveiled
on Aug. 4, is designed so participating insurance companies can
access aggregated claims information from the database to obtain
feedback about what is driving health care costs.
That information is something the employer clients at Blue Cross
are demanding to see, said David Plocher, chief medical officer of
Blue Cross and Blue Shield of Minnesota.
"This is a competitive advantage, as we want to get more
business from large and multistate self-insured employers," said
Plocher, who is also the senior vice president of informatics for
the association's BHI project. "This tool allows us to more
accurately diagnose the causes of health care costs."
Plocher also claimed that it will do so "at a level of precision
no one else can do."
As a result, he added, employers will be able to compare their
health care costs with those of other companies in their own
industries in other parts of the country.
The database, which has cost US$45 million over the past two
years to build and will be operational by early next year, will be
operated by El Segundo, Calif.-based Computer Sciences
Corp. on a central server in Delaware, Plocher said.
The participating plans will send their claims data -- stripped
of any identifying information -- to that central server. When they
want to get analysis of data from the other participating plans,
they will submit a request to a programmer, who will extract the
data based on varying parameters such as employer name, geographic
location or disease types, Plocher added.
The BHI already has a common data dictionary for the regional
insurers to use when reporting their information to the database so
"there will be no inaccuracy introduced by that sort of variation,"
according to Plocher.
Putting data into context
Kyle Marshall, a spokesman for Blue Cross and Blue Shield of
North Carolina, which is participating in the BHI project, said
that until now, the company had limited access to claims data from
other Blue Cross/Blue Shield plans nationwide for analysis.
"If an employer group sees that its own claims data shows it has
a lot of employees with claims for diabetes... how do they put that
into context? What can they do with that data?" Marshall said.
Using BHI, that information can be mined with other data through
a common tool, he said.
For example, he pointed out that a furniture manufacturer could
compare its claims data for a particular health problem with that
of other furniture manufacturers or other similarly sized
companies.
Scott Tiazkun, an analyst at IDC, said the BHI project is
significant for several reasons -- most notably its size. By
compiling claims information on 79 million patients, the database
will be much larger than those envisioned by regional health
information organizations, he said.
"From a data mining and disease management perspective, a pool
of patients and data information this large could be a great
opportunity," Tiazkun said.
The BHI system, he noted, "could apply analytic applications to
the data to determine disease trends among various populations,
like smokers, nonsmokers, people over 50," which ultimately could
lead to more effective treatment.
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