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Category: Consumerism

27 Aug 2019

BCS Financial Adopts Blue Health Intelligence’s Predictive Model to Help Health Plan Members with Serious and Expensive Health Conditions Earlier

To view the full press release via BHI, click here.

CHICAGO (August 27, 2019) – BCS Financial Corporation (BCS), which provides insurance and financial products to Blue Cross Blue Shield Companies, has selected Blue Health Intelligence®’s (BHI®) award-winning predictive algorithm to identify members who have or may develop health conditions that cost more than $250,000 a year. The goal is to help individual Blue Plans work with these high cost claimants (HiCCs) to improve their health outcomes and mitigate escalating expenses.

While HiCCs represent fewer than one in 1,000 of all Blue Plan members, they are expected to generate nearly $20 billion in annual costs by 2022. In developing meaningful solutions for this vulnerable population, BHI found that three of every five high cost members are new or emerging, and many suffer from heart disease, cancer, or neurological disorders. The remaining 40% have recurring high costs each year, and typically suffer from chronic conditions such as blood disorders, metabolic illnesses, and renal disease. Contributing factors for all HiCCs include specialty drugs, new genetic therapies, and advanced treatments such as cancer immunotherapy.

The BCS and BHI HiCC solution, currently being implemented by five Blue Plans, is called the High Cost Predictor Algorithm (HCPA). It uses machine learning to efficiently achieve the needle-in-a-haystack work of identifying who among tens of millions of Plan members will reach or exceed more than $250,000 in annual costs, including a few thousand whose care is expected to exceed $1 million per year. Earlier this year, BHI was recognized by MedTech Awards as having the best predictive analytics solution.

“BCS is committed to helping Blue Plans and their members achieve high-quality healthcare at a lower cost through a variety of tools and reinsurance solutions, and we are thrilled to add this leading-edge solution to our cost-containment offerings,” said Peter Costello, BCS Financial’s president and chief operating officer.

BHI specifically trained and validated the HCPA using longitudinal claims information from more than 190 million Americans in its National Data Repository, along with publicly available socioeconomic and claims derived data. BHI’s data scientists evaluated thousands of predictive variables to isolate the clinical complexities, utilization patterns, and contextual factors most closely linked to extremely high costs.

“The combination of BHI’s machine learning, artificial intelligence, and clinical validation make these predictions extremely scalable, actionable, and accurate,” said Swati Abbott, BHI’s CEO. “As a result, BHI is proud to be supporting BCS’ early identification efforts to help lower members’ high costs and improve their health experiences.”

The HCPA is now part of the BCS Risk Navigator suite of cost-containment solutions. Using its National Data Repository, BHI augments the predictive model output with additional historical insights on each member to aid nurse reviewers.

01 Oct 2018

Five Ways Employers Can Help Employees on the Path to Financial Wellness

According to a PwC survey, 54% of employees are stressed about their finances. * And it’s no wonder, since the majority of Americans are unable to cover a $500 or $1,000 unplanned expense. **

Insurance professionals may be in a unique position to help employers address this issue, which can impact employee productivity and a company’s bottom line. But how? Here are five ways employers can help their employees save for a rainy day. (more…)

10 Sep 2018

BCS Financial Announces EssentialCare Group Hospital Indemnity Product

Product Provides Affordable Solution to Protect Against Rising Costs of Hospital Stay

OAKBROOK TERRACE, Ill., Sept. 10, 2018 – BCS Financial announces today a new hospital indemnity product available to help consumers pay for out-of-pocket medical expenses related to hospitalization. The product, underwritten by BCS Insurance Company, is now available in 37 states. (more…)

02 Jun 2014
Blue Cross Blue Shield supports wellness initiatives. | BCS Financial

CVS Stops Selling Cigarettes

Dianne Jimenez

Blue Cross and Blue Shield has been a proponent of wellness initiatives for years. 4 Ever Life also encourages wellness by promoting separate smoker and non-smoker rates on our GUL program, marketed exclusively to Blue Cross and Blue Shield employees and their families. (more…)