The Society of Actuaries (SOA), the Kaiser Family Foundation, and the Healthcare Financial Management Association (HFMA) have joined forces to leverage big data analytics and research to lower healthcare costs.
Caring for patients with chronic diseases accounts for a big majority of US healthcare spending which is the highest in the world and still rising. Yet despite this massive spending amounting to 18% of the US GDP, a 2017 Commonwealth Fund study of 11 developed countries ranked the US last in the overall quality of care.
Jessica Kent reports on the effort to find data-driven solutions for rising care costs in this article in Health IT Analytics:
Stakeholders identified chronic disease management as a major reason for high care costs. SOA stated that 86 percent of healthcare spending is attributed to patients with one or more chronic conditions, and that chronic diseases cause seven out of ten deaths in the US. Pharmaceuticals and administrative costs also contribute significantly to increased spending.
Promising solutions for combating healthcare costs include improving medical imaging technology, exploring advanced genomics, and leveraging big data analytics to support value-based reimbursement models and more proactive interventions, the group said.
“The United States has a higher prevalence of obesity, for example,” Pauley said. “If we’re going to tackle the obesity problem, we need to get an idea of the value of obesity interventions, such as weight loss or exercise programs.” “When we look at all those types of things, we have to identify how the healthcare system can leverage data and knowledge to achieve financial outcomes projected by research efforts.”
“We formulated three initiatives that will establish some defined strategies to address the identified problems,” said Pauley. “One initiative, called Managed Care 3.0, will explore the promise of value-based reimbursement, with an emphasis on understanding analytical techniques. The second will aim to increase transparency in the pharmacy development and pricing process. The third is an SOA-sponsored initiative, called the 5/50 Research Project, which will focus on the five percent of the population that incur 50 percent of healthcare spending in the United States.”