Big Insurer, Big Information!

Healthcare Data Driven IndustryLater this year, heavyweight insurer Blue Cross and Blue Shield Association will transform their healthcare data analysis service into its own business. Founded only 4 years ago, Blue Health Intelligence reviews millions of claims and details how healthcare is being put to use by policyholders. Claiming its database surpasses that of the government, Blue Health Intelligence uses its analysis to determine trends and offer insights to quality of coverage – a service that is quite cost effective.

Current trends in the industry, spurred by looming legislative reform, are suggesting that standards of care are becoming more data-driven. Blue Cross and Blue Shield stand to boost their revenue by a sizable margin, but this development also means that customers and hospitals could be privy to the breadth of information Blue Health Intelligence draws from insurers.

This initiative raises concerns with the American Medical Association, as well as other groups, who claim that the data gathered is used to promote cheap doctors rather than quality care. Accompanying these concerns are a bevy of lawsuits confronting companies on whether claims data is being put to use as claimed.

Insurance providers and physicians are beginning to come together over the issue, opting to use electronic records regard patients insurance and how they use it, which can be accessed by healthcare professionals across a wide network.

“Regardless of what data is put together or how it is construed there is always the concern that quality is what costs less,” says director of communications and marketing for Ohio State Medical Association. “That is not the cornerstone of healthcare delivery.” He also expressed a concern that there could be “a very slippery slope” when using this newly available data and how it may compromise quality health care just to save money.  

Blue Cross and Blue Shield have established a $28 million fund for this venture and incorporation documents were filed in December of last year. The company – dubbed simply Health Intelligence – has yet to assign a CEO.

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