Enhancing efficiency in the health care industry

Document Type

Article

Publication Date

12-1-2005

Abstract

The benefits of incorporating American Healthways Corporation's (AMHC) predictive modeling to more accurately identify patients likely to develop chronic illness are discussed. One way to enhance operational efficiency in the health care sector is by more accurately identifying the sources of future high resource demand and initiating strategic management tactics to mitigate the potentially significant costs of fully developed illness. AMHC uses an empirical claims-based approach to predictive modeling and risk stratification with the purpose of creating a model that correctly identifies future high-risk patients based on information derived from a health plans. It collects and processes all relevant medical claims, pharmacy, lab results, and clinical data to develop, calibrate and implement predictive model. It utilizes a wide array of artificial-intelligence based statistical and econometric methods to investigate the data and create a predictive model.

Identifier

33745200729 (Scopus)

Publication Title

Communications of the ACM

External Full Text Location

https://doi.org/10.1145/1101779.1101785

e-ISSN

00010782

ISSN

00010782

First Page

107

Last Page

110

Issue

12

Volume

48

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