Health insurance is primarily in the business of receiving premium from policyholders and paying for their medical expenditure. To do that, the health insurance companies need to ensure that the premium charged is sufficient to pay for these medical and administrative costs. Analysts new to health insurance might find these concepts difficult to grasp. Some … Continue reading Health Insurance Analytics Metrics
Tag: data
EHRs, what’s all the fuss about?
EHRs… ahhh, love them, hate them. If you do any work in the medical space, you will need to interact with them. In this post, I talk about what they are, what they do, their strengths and weaknesses. What are they? EHRs (electronic health records) are digital records of patient’s clinical records. EHR platforms are software platforms … Continue reading EHRs, what’s all the fuss about?
Practical considerations for Predictive Modeling
Advances in computing power and in machine learning techniques are rapidly changing how humans utilize data. Aside from the core statistical issues, what are the questions that an analyst needs to consider when doing predictive modeling in practice? This post describes a few of these practical considerations. I like to use the 5 Ws to … Continue reading Practical considerations for Predictive Modeling
Risk Adjustment 101
In this post, I describe risk adjustment, an important tool in health analytics. I’ll cover what it is, how it is used, how it is done and how well it performs. What it is In the sport of boxing, matches are held between two boxers of the same weight class and gender. A match would … Continue reading Risk Adjustment 101
On Opioids and Analytics
In this post I describe how I would go about using health analytics to identify patients most at risk of an opioid overdose. The Facts In 2016, there were 42,249 deaths in the US that involved opioids. That equates to a 13.3/100,000 mortality rate, and approx. one opioid related death every 10 minutes! By the time … Continue reading On Opioids and Analytics