Predictive analytics help Humana identify gaps in care

Humana has been an early IT adopter, making analytics the foundation of its clinical operations and consumer engagement efforts--and has reaped the benefits, reports Enterprise Apps Today.

"Every touch point with the healthcare system yields data, whether it's a physician visit or a visit to a hospital or an outpatient facility," Vipin Gopal, Humana's enterprise vice president of clinical analytics, told the publication. "We use analytics to understand what can be done to improve health outcomes."

The insurer's predictive models have already helped it identify almost 2 million members at high risk of diseases and closed 4.3 million instances of gaps in care by identifying which members would benefit from regular communication with a provider.

Predictive analytics also helped Humana lower hospital readmission rates by about 40 percent by using real-time analytics to determine which members were most likely to be readmitted.

Its more than 15,000 care managers and other professionals help coordinate care for its members, ensuring they make changes to lifestyle, diet and other areas. And all of those efforts are powered by analytics, Gopal noted.

Although most insurers haven't seen "analytics as a key component of doing business," Humana has benefited from a mature technology infrastructure, a supportive CEO and an analytics team composed of professionals with different backgrounds.

"These are deep problems, and we need the best multidisciplinary talent working on them," Gopal said. "It's not something just public health people can solve, or just computer science people can solve."

Humana also uses application program interface to create better ways to use and share information, FierceHealthIT previously reported.

To learn more:
- read the Enterprise Apps Today article

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