Blue Cross compiles health care database

Earlier this month, the national Blue Cross and BlueShield Association announced an initiative to compile claimsinformation from 79 million patients into a database that can be shared with 20participating Blue Cross plans.

The Blue Health Intelligence (BHI) project, which was unveiledon Aug. 4, is designed so participating insurance companies canaccess aggregated claims information from the database to obtainfeedback about what is driving health care costs.

That information is something the employer clients at Blue Crossare demanding to see, said David Plocher, chief medical officer ofBlue Cross and Blue Shield of Minnesota.

“This is a competitive advantage, as we want to get morebusiness from large and multistate self-insured employers,” saidPlocher, who is also the senior vice president of informatics forthe association’s BHI project. “This tool allows us to moreaccurately diagnose the causes of health care costs.”

Plocher also claimed that it will do so “at a level of precisionno one else can do.”

As a result, he added, employers will be able to compare theirhealth care costs with those of other companies in their ownindustries in other parts of the country.

The database, which has cost US$45 million over the past twoyears to build and will be operational by early next year, will beoperated by El Segundo, Calif.-based Computer SciencesCorp. on a central server in Delaware, Plocher said.

The participating plans will send their claims data — strippedof any identifying information — to that central server. When theywant to get analysis of data from the other participating plans,they will submit a request to a programmer, who will extract thedata based on varying parameters such as employer name, geographiclocation or disease types, Plocher added.

The BHI already has a common data dictionary for the regionalinsurers to use when reporting their information to the database so”there will be no inaccuracy introduced by that sort of variation,”according to Plocher.

Putting data into context

Kyle Marshall, a spokesman for Blue Cross and Blue Shield ofNorth Carolina, which is participating in the BHI project, saidthat until now, the company had limited access to claims data fromother Blue Cross/Blue Shield plans nationwide for analysis.

“If an employer group sees that its own claims data shows it hasa lot of employees with claims for diabetes… how do they put thatinto context? What can they do with that data?” Marshall said.

Using BHI, that information can be mined with other data througha common tool, he said.

For example, he pointed out that a furniture manufacturer couldcompare its claims data for a particular health problem with thatof other furniture manufacturers or other similarly sizedcompanies.

Scott Tiazkun, an analyst at IDC, said the BHI project issignificant for several reasons — most notably its size. Bycompiling claims information on 79 million patients, the databasewill be much larger than those envisioned by regional healthinformation organizations, he said.

“From a data mining and disease management perspective, a poolof patients and data information this large could be a greatopportunity,” Tiazkun said.

The BHI system, he noted, “could apply analytic applications tothe data to determine disease trends among various populations,like smokers, nonsmokers, people over 50,” which ultimately couldlead to more effective treatment.