Ever wonder who sorts through all the data that powers your all-knowing health insurance company? Samuel A. McKinney did. McKinney was surprised to find a concerned letter from Blue Cross Blue Shield in his mailbox wondering why he had stopped taking his medication: Immediately consult a physician about your medication if it’s too expensive or causing side effects, the insurer advised. Trouble was, he had just filled the prescription.
So, he called and discovered that Resolution Health, a Columbia-based health analytics firm, was helping insurers keep closer tabs their members. Armed with a massive databases — medical and pharmacy claims, lab reports, provider reports and other statistics — Resolution analyzes personal health information. More than 1,000 computer algorithms dissect the data for millions of members, scanning for ways to cut costs, eliminate conflicting medications and avoid lapses in treatment.
When a problems are identified, letters, much like this one, are sent out to patients such as McKinney and their doctors.
As it turns out, Blue Cross wasn’t informed that McKinney, a retiree who lives in Salem, Ohio, gets his drugs through a military pension program.
McKinney forgave the oversight.