Applications of Big Data in Healthcare - Part 3
With the advent of Health insurance exchanges as part of healthcare reform initiatives in the United States, the insurers/payors will have to sell a subset of their plans through the state-level public exchanges. The members will have the facility to compare the plans sold by different insurers before taking the final purchase decision. The payors have come up with private insurance exchanges where they are selling health plans to typically large employers.
The payors will face several challenges in order to maximize their sales through exchanges.
• How to capture the healthcare needs of the members or employees which can be incorporated in the health plans sold through the exchanges
• How to accurately calculate the health insurance premiums for the plans sold in exchanges so that it will be lucrative to the members without compromising the profitability
• What are the various wellness programs that can be offered as part of the benefits in plans sold through the exchanges
• The employers and the members alike will look forward to health insurance exchanges for reducing costs and getting adequate healthcare choices
The solutions to above challenges are dependent on how accurately the needs, interests of members/employees are predicted. The health analytics will play a key role in helping payors achieve the accuracy.
There are a lot of discussion forums, feedbacks on the performances of the health plans offered by the payors which are available in public sites. This information is huge in size and can be systematically analyzed to understand the member mindset as far as healthcare spending is concerned. Big Data algorithms will find a useful application here in order to achieve this accurately and provide the additional intelligence to the payors.
Big data can be leveraged for unstructured data analysis in the following areas.
• Members' buying and spending patterns in Health insurance
• Members' spending and participation patterns in wellness programs
• Health habits of different groups of member populations
• Healthcare choices availed by the employers (Large / Small Groups)
• Further enhancing exchanges with additional facilities so that more healthcare choices can be provided with less cost.