Predictive Modeling Bulletin             |           November  2, 2010             |           Volume Two Issue Eleven
Complimentary from the publishers of Predictive Modeling News      www.PredictiveModelingNews.com

"Emerging predictive modeling functionality enables payers to establish rules within claims software to alert the system to coding anomalies. Intelligence based on diagnostic and procedure regulations can be programmed into the software to automatically flag coding practices outside of the norm. These rules would cover national and local coverage determinations and payer-specific guidelines, as well as imbedding alerts to common errors or emerging trends." Rodger Smith, Senior Vice President for Claim Audit and Recovery Services, SCIOinspire Corp.
 

SAS® Predictive Analytics optimized for discovery, analysis, accelerated results
SAS Press Release, October 25, 2010 

Lyzasoft Integrates Low-cost Predictive Analytics into its Data Analytics and Collaboration Platform
InsuranceNews.Net, October 18, 2010 

Predictive Modeling May Reduce Hospitalizations
HealthLeaders Media, October 12, 2010 
 
Predictive health shows promise for changing U.S. health care delivery
Physorg.com October 12, 2010 
 
Swedish insurance company shifts from 2 direct marketing campaigns a year to 13 a day thanks to predictive analytics
IBM Success Stories, October 12, 2010 
 
A Predictive Model for Venous Ulceration in Older Adults: Results of a Retrospective Cohort Study
Ostomy Wound Management, Issue Number: 2010;56(4) 
 

In the November 2010 issue of Predictive Modeling News, you'll find articles including:

• Innovative Applications of Risk Adjustment for the Evaluation and Financing of Medical Homes by Phi Ho, Business Analyst, Verisk Health

• Predictive Modeling and Analytics Help Prevent Claim Overpayments, by Rodger Smith, Senior Vice President for Claim Audit and Recovery Services, SCIOinspire Corp.

• Pact Uses Social Networks to Improve Health, Well-Being Using social influences to increase the rate and sustainability of behavior change

• Managed Care Pharmacists Study Predictive Aspects of Medication Therapies

• The Missing Piece in Risk Adjustment for Medical Management by Ksenia Draaghtel ASA MAAA, Associate Actuary, Milliman Inc.

• Thought Leaders Corner: “How can predictive modeling initiatives best be positioned to take advantage of increasing EHR adoption under ‘meaningful use’ requirements? What adjustments and changes should be made to capitalize on this opportunity?”

• Industry News with briefs regarding Reed Group, Texas Rehab Department, Ontario Institute for Cancer Research, Privacy Analytics, Ingenix, Quality Metric, TerraMedica, Bioseek, Cellzome, and Express Scripts

• Catching Up With...Peichang Shi, Programmer and Statistician in Pharmaceutical Research Computing,
  University of Maryland, Department of Pharmaceutical Health Services Research, Baltimore, MD

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