Predictive Modeling Bulletin
  Complimentary from the publishers of Predictive Modeling News                   April 3, 2012  
 
Predictive Analytics, MSSP & Star: Relating & analyzing these Medicare programs for hidden compliance & enrollment patterns
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Quote
  "Property and casualty insurance focuses on financial risk in contexts and circumstances that are predictable and generally straightforward. Predictive modeling tools in the P&C industry are fairly strong, their accuracy is high and available risk data are probably adequate. The situation in healthcare, I believe, is far more complex. Healthcare needs, patterns and risk data are more nuanced and multi-faceted and, unlike P&C, predictions focus as much on consumer or provider behaviors or actions as on dollar outcomes. There is always something that we in healthcare can learn from other industries, but I would think the parallels between the two industries may be limited and therefore the lessons limited as well." Jonathan Weiner DrPH, Professor, Health Policy and Management; Director, PhD Program in Health Services Research and Policy; Deputy Director, Health Services Research & Development Center, The Johns Hopkins University
 
 
Factoid
  65% of providers said supporting organizational strategies, like participating in new care delivery or reimbursement models, was a top clinical informatics goal in the next two years. But, 58% expressed challenges in prioritizing what to work on first.

Excerpted from Needles in a haystack: Seeking knowledge with clinical informatics, PricewaterhouseCoopers
 
What's News
  Quintiles to Quantify Healthcare Decisions Using Archimedes Simulator
Business Wire, March 28, 2012
 
     
  Where Does Predictive Modeling Stand
Becker's Hospital Review, March 21, 2012
 
     
  Fighting Fraud: Predictive Analytics & Business Rules Make a Powerful Combination
Insurance & Technology, March 19, 2012
 
     
  Health Professionals Demanding Clinical Informatics
CIO Insight, March 14, 2012
 
     
  Life Insurers Right in the Middle of a Big Opportunity
LifeHealthPro, March 14, 2012
 
     
  Texas doctor indicted in $375 million health care fraud scheme
American Medical Association, March 8, 2012
 
     
This Month in Predictive Modeling News
 
  • Fighting Healthcare Fraud Using Social Network Analysis: The Optimal Approach by Julie M. Malida, Principal for Healthcare Fraud, Enterprise Financial Crimes Practice, SAS
  • Researchers Emphasize Potential Unintended Consequences of Model Use
  • Concurrent Risk Adjustment by Ksenia Draaghtel, Milliman
  • Gilsbar Will License Elsevier/MEDai’s Risk Navigator Clinical to Identify and Manage High-Risk Populations and Improve Patient Care Quality
  • Actionable Analytics: 10 Steps to Improve Profitability & Patient Experience Through Data-Driven Decision-Making - CareCloud Corporation
  • Thought Leader’s Corner - “Why does it seem that the property & casualty industry has embraced -- and invested more in -- predictive analytics than healthcare? What, if anything, can healthcare learn -- or emulate -- from the P&C industry in that regard?"
  • Industry News with briefs regarding Johns Hopkins ACG International Risk Adjustment Conference, Government Employees Health Association, FICO, Verisk Health
  • Catching Up With... Pamela B. Peele PhD
  • Click here to view page one of this issue
  • Click here to subscribe to Medical Home News, or find out more
 
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About the Bullletin
  Predictive Modeling Bulletin is a complimentary publication issued periodically from the Health Policy Publishing, LLC, the publisher of Predictive Modeling News (www.predictivemodelingnews.com) Your friends and colleagues can subscribe to Predictive Modeling Bulletin at no charge by visiting: http://www.predictivemodelingnews.com/resources.html