Corporate Research. Economic analyses for public and private publications.
HSI Network’s client projects traverse the Fortune 500 and include hospital systems, health insurers, biotechnology firms, medical device manufacturers, and software developers. For each project we build a team of the best experts from leading universities and pair them with our policy and business strategy professionals to deliver a final product that leverages state-of-the-art academic analysis for practical use in the corporate world.
Development of a Medical Productivity Index for Health Insurance Beneficiaries
Publication: Journal of Insurance Markets and Companies
In this paper, a Medical Productivity Index (MPI) is proposed as such a metric to capture the value of care received by patients from medical providers. For the health sector, such a metric could address the growing concern that medical care expenditures are sapping the economic vitality of a nation if these outlays show a productivity gain. The two primary components of the MPI are a measure of health outcomes and a measure of medical care effort. The MPI is applied to a national sample of Medicare 2007-2009 claims data. Application of the MPI shows both a cyclical and long-term trend in medical care productivity. There are substantial regional variations in MPI as well. Extensions of the MPI could provide disease and insurance contract specific sub-sector component comparisons in future applications. The use of MPI to retrospective claims and contemporary claims data provides a technology to track changes in medical productivity to gauge the impact of future health reform and medical technologies as well as an aging society to patients and the health care industry.
Exploring Ex Ante Regulatory Mechanisms for Detecting Prescription Drug Misuse
Publication: National Bureau of Economic Research
This chapter presents an exploratory analysis of the extent to which prescription drug abuse for pain medication could be identified prospectively for intervention by health insurers, and supported by law enforcement and the medical community. The chapter proceeds first with a general distinction between misuse and abuse, and how its remedy would be considered in the insurance contract. The second part of the chapter describes the current ex post process for detection after it has occurred by police and law enforcement. The third part presents an ex ante alternative to the ex post “litigation” approach. This alternative approach applies expert systems designed by doctors/ pharmacists/ statisticians/ law enforcement/ economists to insurance claims data in order to screen high probability misuse for intervention and education. The fourth section demonstrates how this “regulation” approach might work using the application of a published algorithm. The chapter concludes with a discussion of how this might work as a regulatory approach, either in the hands of law enforcement or private health plans.
Health Information Technology and Financing’s Next Frontier: The Potential of Medical Banking
Publication: Business Economics
Calls to action for widespread adoption of electronic health records have come from a broad spectrum of the private and public sectors. The problem, to date, is not that information does not exist, as much as that the data have not been organized around the patient. An integrated Personal Health Record is a patient- or family-centered technology designed to capture not only the contacts with health care providers, but also personal information on insurance, diet, and personal preferences that a physician’s health record will not capture. Medical banking, based on a new technology platform called the Integrated Health Card, is emerging as a solution to the problem of collecting and combining information from the electronic health record with personal health information. It may also be the only way for fledging health savings accounts to enable the price and quality transparency of the medical market that has been called for repeatedly in this decade. In analyzing the political and patient applications of widespread adoption of this new innovation, the positive contributions to social welfare are very likely to outweigh the negative.