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The effect of predictive analytics-driven interventions on healthcare utilization

Guy David, Smith-McLallen, Aaron and Benjamin Ukert

Journal of Health Economics, 2019, vol. 64, issue C, 68-79

Abstract: This paper studies a commercial insurer-driven intervention to improve resource allocation. The insurer developed a claims-based algorithm to derive a member-level healthcare utilization risk score. Members with the highest scores were contacted by a care management team tasked with closing gaps in care. The number of members outreached was dictated by resource availability and not by severity, creating a set of arbitrary cutoff points, separating treated and untreated members with very similar predicted risk scores. Using a regression discontinuity approach, we find evidence that predictive analytics-driven interventions directed at high-risk individuals reduced emergency room and specialist visits, yet not hospitalizations.

Keywords: Predictive analytics; Cost containment; Population health management (search for similar items in EconPapers)
JEL-codes: I10 I12 I19 (search for similar items in EconPapers)
Date: 2019
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Journal of Health Economics is currently edited by J. P. Newhouse, A. J. Culyer, R. Frank, K. Claxton and T. McGuire

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