By Jane Anderson
Premera Blue Cross has broadened its partnership with predictive health care analytics startup Cardinal Analytx Solutions with a view toward identifying why certain individuals have extreme escalations in medical treatment.
Cardinal Analytx’s machine learning models “can predict members with near-term care needs, accurately and consistently over time,” says Colt Courtright, director of corporate data and analytics at Premera. He adds that the Blues plan has found these members are willing to engage in care management support. This indicates the program both will help members and eventually show a population-level return on investment, he says.
Premera and Cardinal are exploring whether to provide primary care physicians with the information, says Nigam Shah, M.D., who founded Cardinal Analytx with lead investor Cardinal Partners. Ultimately, “we want to use AI to improve a patient’s health trajectory, empower the PCP with more information, and remove clinical and financial burdens on the patient,” Courtright says.
At BlueCross BlueShield of Western New York and BlueShield of Northeastern New York, data teams now are able to identify members who are pre-diabetic through predictive analytics, and then engage them to ensure a proper care plan is in place, says Adam Dunning, director of health care economics for the New York Blues plans.
Meanwhile, Health Care Service Corp. has focused on analytics for providers “to make it easier for providers to gain insight into their quality of care and close care gaps,” according to Gary Stanford, vice president and actuary, HCSC provider network analytics.