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When selecting the right population for a health intervention program, authors Colbert and Ganguli emphasize the necessity to “look beyond big data.” Wellness programs are not one size fits all, and success can be largely dependent on proper identification. Claims-data and patient charts are not the only tools that should be used for identifying participants for a program. In an April Health Affairs blog, Colbert and Ganguli comment on discoveries that Benefit Performance Associates (BPA) commonly finds in analyzing health claims data; five percent of the workforce is spending fifty percent of healthcare dollars.
A majority of this percentage also tends to suffer from multiple chronic conditions. Often times, psychosocial elements go unnoticed in “big data.” Advocates from the Integrated Health Advocacy Program® (IHAP®) report an underutilization of necessary prescription drugs for a variety of reasons spanning from undiagnosed and untreated conditions to financially being unable to pay for the medication prescribed. To read more on the historical utilization of IHAP participants, click here.
For more than 15 years, the Integrated Health Advocacy Program has been a solution for thousands of participants who not only benefited from adding the often missing behavioral health care component to treatment, but also addressing other misdiagnosed or undiagnosed conditions. With integrated care, patient demographics and insight are better understood, resulting in a more effective care plan. IHAP utilizes health claims data as well as an advocate’s insight to best identify this population.
Colbert, J., Ganguli, I. (2016) To Identify Patients for Care Management Interventions, Look Beyond Big Data. Health Affairs Blog. Retrieved from: http://healthaffairs.org/blog/2016/04/19/to-identify-patients-for-care-management-interventions-look-beyond-big-data |
