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Big Data Helps Insurer Pinpoint At-Risk Patients
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pcharles09
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pcharles09,
User Rank: Ninja
6/30/2014 | 6:16:54 PM
Hmmm...
That seems good & scary all at the same time. I feel like having this information is good for the healthcare professionals. But the HMOs & insurance companies may use this to start dropping patients ahead of time. I don't know if it's a sure thing but someone once told me that the objective of big data in insurance is to figure out who NOT to cover, not the other way around.
Alison_Diana
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Alison_Diana,
User Rank: Author
7/2/2014 | 3:42:34 PM
Re: Hmmm...
You raise a good point. Under Obamacare, insurers can no longer deny coverage or drop someone due to a pre-existing condition -- but that doesn't mean your rates won't be higher if you have a condition than if you don't. It's not only insurers and other payers (such as government or employers -- although it's illegal to not hire someone because of their health, unless it's part of the job -- such as the job requires you to lift 50 pounds). Marketers and pharmaceutical companies want this data to advertise to us and also to help in their drug-development plans. 

I worry about the point at which this all intersects: What happens if our supermarket loyalty cards, our debit/ credit cards, our personal health information, and data from all these health apps and wearables comes together? What happens when a payer sees that, although you go to the gym four days a week, you also buy a carton of Camel unfiltered and buy two cases of beer, 1 bottle of vodka, and fast food dinners every other night?
pcharles09
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pcharles09,
User Rank: Ninja
7/22/2014 | 9:08:41 AM
Re: Hmmm...
@Alison,

They might still consider you heathly. In the best case scenario, you break even. It'll be like an equation: if Gym - all the bad stuff = 0
AnfH156
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AnfH156,
User Rank: Apprentice
7/2/2014 | 12:14:26 PM
Risk Vs. Reward
I think you are correct, I agree with you completely. This can be very scary and beneficial at the same time. With anything, we must evaluate the risk and reward of the technology we trust to ensure the cost and effectiveness of our healthcare. Being we cannot control how Insurance companies and healthcare institutions use or interpret the information, we can only hope they do not abuse it. But companies like Due North Analytics are the wave of the furture when it comes to tracking and analyzing medical data for the healthcare industry. 
Alison_Diana
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Alison_Diana,
User Rank: Author
7/2/2014 | 4:00:01 PM
Benefits Outweigh Worries
In this particular case -- with Aetna and GNS -- I have no qualms about how the data was used because patients opted in and clearly understood who was using their data and what it was being used for. When an organization uses individuals' information in such a transparent way, clearly telling patients what they are doing with the data, and patients directly benefit then I don't find there to be any privacy issues. Rather, data is being used to help individuals' health. Sure, it saves money -- but it really means people could well be on the path to better quality, longer lives, and that's a benefit you can't beat!


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