15. Using Advanced Analytics to Take Action for Health Plan Members’ Health
“Hot spotting” has practically become the battle cry for managed care organizations since an article of the same name was published in The New Yorker in January 2011 (Gawande, 2011). In this article a physician, Jeffrey Brenner, realized after attempting to save a shooting victim it was possible to study healthcare utilization patterns in much the same way assault and crime patterns are tracked. For example, Brenner discovered that across a six-year period, more than 900 people in Camden, New Jersey, accounted for more than $200 million dollars in healthcare expenses. One of these patients had 324 admissions in five years ...
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