blue cross & blue shield of rhode island new approaches focusing on dynamic variables related to...
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3 History of Predictive Modeling at Blue Cross & Blue Shield of Rhode Island 1990s Rules based predictive models used for Case Management identification Began researching Predictive Modeling/Data Mining methodologies and software Developed Predictive Models for Case and Disease Management using statistical methods Incorporated Johns Hopkins Predictive Models output into Case and Disease Management Initiatives Beta tested Johns Hopkins Predictive Modeling Software Timeline 2006 Incorporated Predictive Models into Underwriting process 2008 Incorporated detailed Pharmacy Data into Predictive Modeling process Included Dental data in Predictive Modeling process when available 2007 Health risk appraisal data included in Predictive Modeling process Introduced dynamic variables to identify changes in member health status for earlier identification Remodeling Process for Disease Segmentation Implemented BHI Risk Score Benchmarks into Account Reporting & Analysis