Are you a bit tired of hearing about risk management and what a “risk” we all are to society at times?  I guess after researching and posting information on this blog with the glut of software and business intelligence software out there, it seems that none of us do a lot of anything right and we will have bundles of algorithms to imagesort through to figure out which ones we can handle and implement into our lives.  These algorithms are being placed both in medical records and on devices that report data that go into a medical record, both EHRs and PHRs. 

I’m afraid the world of analytics is shortly going to throw way to much at us to handle, but more importantly the information will be utilized to give consumers a “score” on their risk.  Imagine, being held accountable for your health, whether you had any impact on the onset of your chronic condition or not.  You will be scored.  From what I have read here too, this company conducts surveys too.  My 85 year old mother just did on one the phone with her Medicare Part D carrier.  This survey was basically to see if she still had her wits about here to include spelling words, selecting multiple choice answers and knowing her address where she lives.  This all leads to the new and somewhat unknown world of “behavioral underwriting”.  In other words what do you do health and otherwise to cause risk.  Personally I think some of this is a bit overdone and we need a 12 step program started for the analytics addicts, as they are creating some very complicated formulas by which we are not able to live and breath as humans at times.

QualityMetrics also wants the patient to understand the economic benefit of your score too.  Did I say that correctly, is this about healthcare or the economics of your care?  Granted like every survey and information gathering system there’s good information attained, but how it is used and analyzed for profits is where the problem lies.  Along with all of this there’s a section whereby the algorithmic processes are used to “predict” medical expenses, we don’t want any more surprises here, right?   As the page suggests this does not include claim data as it takes too long to get, so they have other methods:

“Pharmaceutical, biotechnology, and medical device companies use this information to link a treatment's benefits to a lower risk of healthcare expenses and to position products for inclusion in formularies.”

See the words connecting devices and pharmaceutical information above?  These are devices that collect and report data that I have been talking about for 2 years that nobody really wants to acknowledge they exist, and for development purposes, the more ignorant the public is, the easier it is to develop such devices.  Also mentioned is the pharmaceutical end of this, so as I have mentioned so many times before, all your medication prescription records are bought and sold, and Ingenix does a lot of this so perhaps they will be combining some of their big transaction money they receive from these transactions. 

Health Insurance Underwriting Practices With Prescription Data – How Does This Work


Ingenix already shows profits over a billion every year for it’s division of United Healthcare, so this looks to be more analytical data to increase those levels.  Again, we are over run with analytics to the point to where in short time there will be additional protests and potential riots. 

Science and Questions of Morality – Can and Do They Work Together (Video)

The link above is my idea of suggested reading that leaders of Wall Street and health insurers should look at to see what their analytics are going.   As mentioned, physicians can look forward to additional complicated formulas to reach that P4P carrot that illustriously hangs in the window.    Most MDs are too busy trying to take care and do the right thing for patient care and many of the algorithm parameters to meet just go way over their heads and they have so little time to even focus, so analytics overdone.  Most that I have spoken to have little time to devote and are hearing in meetings at their hospitals that the hospital is “not meeting their quotas”, so they are getting all sides of the puzzle.  The algorithms are carving profits from hospitals and doctor compensation and make for dividend payments for shareholders.  BD   

From the Website:

“QualityMetric scientists can help you translate patient-reported information into knowledge and results. Whether you are seeking a label claim or need assistance with an FDA dossier, QualityMetric will guide you every step of the way. Equipped with our proprietary databases, our scientists can also help you to identify future health risk, understand the distribution of disease burden in member populations, and assess treatment effectiveness.”

*Cost-utility and cost-benefit analyses are conducted in order to determine the relative benefits gained from a variety of medical procedures or intervention programs in terms of quality adjusted life years.

“QualityMetric's reliable and scientifically valid generic health surveys, including the SF-12v2® and SF-8™, are perfect for measuring population health. They identify people at risk for a variety of chronic conditions, both at present and in the future. Additionally, these surveys can measure disease burden in select populations.

The benefits of using our health surveys are far-reaching. When you make patients aware that they are at risk for a chronic condition, they can get the help, information, or treatment they need. That, in turn, can cut down on absenteeism in the work force. And the ability to monitor the ups and downs of a person's condition on a long-term basis with a survey that is easy to use and produces instant results, enables healthcare providers to assess treatment and make changes accordingly.”

UnitedHealth Group Inc. health  information and technology subsidiary Ingenix announced Wednesday that it has acquired QualityMetric Inc. for an undisclosed amount.

Lincoln, R.I.-based QualityMetric provides products and services that help health care companies assess patient-reported outcomes — a measurement of the ultimate effectiveness of health care as reported by the patients themselves.

Ingenix said QualityMetric’s offerings will augment the existing capabilities of its life sciences business, i3. “QualityMetric’s [patient-reported outcomes] capability complements our clinical outcomes and medical expenditures research by providing a critical new component — patients’ assessments of their own health status — to the insights that i3 can deliver for our clients,” i3 Group President Brian Kelly said in a statement.

QualityMetric’s capabilities also will complement Ingenix’s existing solutions for helping health care payers measure the quality and cost of care, which can be used to rewards health care providers for quality outcomes.

UnitedHealth subsidiary Ingenix buys QualityMetric - Minneapolis / St. Paul Business Journal:


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