As you surely know, Geneia is an analytics and services company. Bottom line, our analytics help health plans and their physician and hospital value-based partners identify the priority members/patients to engage and activate.
I have previously shared my philosophy, which is:
- Product success equals client success
Further, I believe a product is successful only when it is:
- Meets client needs,
- Is fully implemented, and
- The client is successfully realizing their goals.
As one who wholeheartedly believes that clients use Geneia’s products and services to realize their goals, I believe it’s important to show prospective clients what they can do with our analytics. In other words, what are the pragmatic uses of Geneia analytics.
To that end, in 2021, I am writing a series of blogs to illustrate how health plans are using Geneia analytics to solve pain points and meet their goals, starting today.
Putting analytics into action to manage COVID-19 deferred care and vaccines
Goal: Identify and engage health plan members who have deferred preventive and chronic disease care during the pandemic and are at high risk for COVID-19 severe impacts.
We know people have deferred healthcare during the pandemic and we know there will be consequences to postponing colon, cervical and breast cancer screenings and care management of chronic diseases.
- Nearly half of employees (44 percent) say they have delayed care.
- The Willis Towers Watson survey of 5,000 employees in October 2020 also found that “29 percent who said their health suffered as a result of cancelling an appointment or treatment, while 40 percent expect their health will suffer.”
- Dr. Norman Sharpless, director at the National Cancer Institute, predicted, “Lack of screenings and treatments could result in almost 10,000 excess deaths from breast and colorectal cancer in the next decade.”
At the same time, research has helped us know which kinds of patients are more likely to experience severe impacts if they contract COVID-19. According to the CDC, seniors and adults with diagnoses such as cancer, heart failure, sickle cell disease and Type 2 diabetes “are at increased risk of severe illness from the virus that causes COVID-19.” Not coincidentally, the CDC has prioritized this group for the COVID-19 vaccine, categorizing them as Phase 1c.
That’s why I’m eager to show you how health plans can use Geneia’s enhanced ID and strat framework to identify and engage high and rising-risk health plan members, that is those who have deferred preventive and chronic disease care during the pandemic and also are at high risk for COVID-19 severe impacts. To identify and engage these members, first, health plans use the COVID-19 predictive model created by the Geneia Data Intelligence Lab (GDI Lab). The model answers the question –
If a patient were to test positive for COVID-19, what is that person’s risk for developing severely adverse health outcomes, such as hospitalization?
Within Geneia’s data analytics platform, a health plan care manager can use the COVID-19 risk category to filter members into high, medium and low risk of severe impacts.
Next, among the COVID high risk population, care managers use the Theon® Platform to identify the patients with the greatest risk from deferred care, such as those with heart failure and diabetes, and the most significant gaps in care. For example, diabetic retinopathy is an eye condition that can cause vision loss and blindness in diabetics. There are no early symptoms, which is why eye exams are critical and are part of the HEDIS® quality measures for diabetics. It’s also why health plans use models like the one from the GDI Lab that predicts which diabetics are likely to experience a diabetes-related complication in the coming 12 months.
To further refine the target population, the system also has the ability to add in an age band of 65+ years old and members with an overall risk score of five or more. Geneia’s data analytics platform integrates social determinant information at the zip code-level, meaning health plans are also able to identify high-risk members in current or emerging COVID-19 hot spots as well as those most likely to use public transportation to commute to work or doctor’s visits.
Geneia’s identification and stratification framework combined with its analytics yields a prioritized, manageable list of high- and rising-risk members for care managers to contact and activate in their health. Health plans can use a similar approach to identify a prioritized list of members for the COVID-19 vaccine which can then be shared with its physician and hospital partners.
That’s Geneia analytics in action.