Data Mining

September 24, 2014 | Anthony Brino

The stakes for improvement and innovation are high in American cancer care, and insurers are trying to wield some of their influence to get a return on investment for their members and their budgets.

August 8, 2014 | Erin McCann

One state is finding new approaches to managing Medicaid frequent fliers.

May 14, 2014 | Anthony Brino

Next year, when Americans go looking for the best surgeon or cheapest MRI, many will have free access to a new comparison service started by three insurance giants.

May 13, 2014 | Anthony Brino

Several million young people purchasing subsidized exchange plans was greated as a positive development for all involved. But being young does not mean being free from chronic or acute illness, as early data on one insurer's new enrollees shows.

May 6, 2014 | Tammy Worth, Contributing Writer

The University of Pittsburgh Medical Center is hoping a cost-analysis system from their Italian transplant hospital will become the future of cost measurement here in the United States.

March 28, 2014 | Karen Appold

As the Affordable Care Act continues to disrupt the health insurance industry, health plans must broaden their definition of risk as they calculate rates and attempt to better understand their members' needs.

March 27, 2014 | Kurt Ullman

The relationship between payers and providers has often been adversarial, but healthcare reform has been changing that, leaving former adversaries trying to figure out how to create new partnerships.

March 4, 2014 | Anthony Brino

The Centers for Medicare & Medicaid Services has a lot of data on Medicare Advantage plans that it should be using to inform policy and make available to the public, according to a new Inspector General report.

February 13, 2014 | Mike Miliard

Optum Labs, the research center founded by UnitedHealth and Mayo Clinic, has added seven new health organizations, which will join in on data mining research to find innovative ways to improve quality and reduce costs.

January 21, 2014 | Mike Miliard

As they try to get a better handle on population health management and member engagement, payers are increasingly looking to consumer-facing technologies for help, according to the latest report from Chilmark Research.

October 21, 2013 | Mary Mosquera

WellPoint is taking a tough stance to try to combat prescription drug abuse and fraud activities that bubble to the surface through predictive analytics and other data runs of its members and their providers and pharmacies.

October 16, 2013 | Mary Mosquera

Blue Cross Blue Shield of Michigan has launched an initiative using claims data to help hospitals across the state better understand their practice patterns compared with their peers, in an effort to improve patient outcomes and manage costs.

September 11, 2014 | White Papers
Learn how health plans and insurers can use Teradata to succeed in today's healthcare environment by engaging with individual consumers through data-driven marketing.

September 11, 2014 | White Papers
Learn how to mitigate risk, stay compliant, and improve financial performance in the health insurance industry using advanced analytics.

September 11, 2014 | White Papers
In this era of healthcare reform, creating a data and analytics-driven environment can help you improve your marketing and operations and the health of your members to give you a competitive edge.

June 2, 2014 | White Papers
Success for payers will be based on their ability to integrate and analyze many types of data, from many sources. Making informatics and medical costs and quality management the last true value proposition for health plans.

May 19, 2014 | White Papers
If your organization enters or changes data manually, or is using a series of macros cobbled together to automate enrollment, claims reprocessing, or panel updates, you’re probably losing time, money, and risking data quality. This study explores the causes, prevalence, and repercussions of these traditional data practices for payers, then shares innovative ways to conquer inefficiency with automation technology.

March 11, 2014 | White Papers
For health insurers, data integrity and visibility are key to successful integration with the Federal Marketplace. However, complex processes and trivial errors can lead to data gaps that impact revenue, profitability and member satisfaction. Adopting a standarized approach to data integrity early in the process is critical to succesfully adapting to the technologies and processes of the Affordable Care Act.

November 20, 2013 | White Papers
Whether they realize it or not, most healthcare payers are losing millions of dollars each year across activities such as COB, subrogation, eligibility, MSP validation, and more. Fortunately, a new generation of "intelligent" cost containment solutions helps cut the losses and achieve significantly improved recoveries, cost avoidance, and increased revenue - all of which support health reform priorities such as medical loss ratio and waste and abuse efforts. This white paper details real-world examples of "intelligent" cost containment success, best practices for improvement, and more.

October 9, 2013 | White Papers
Healthcare reform is transforming the US medical insurance sector - creating a dynamic and competitive new market with compelling opportunities for growth. But do you have the necessary responsiveness to capitalize on these opportunities? Here are the five compelling ways technology investment delivers agility you need - and how.


Advertisement. Closing in 15 seconds.