Using Advanced Analytics to Take Action for Health Plan Members’ Health

“Hot Spotting” has practically become the battle cry for managed care organizations since an article of the same name was published in The New Yorker in January 2011 (Gawande, 2011). In this article a physician, Jeffrey Brenner, realized after attempting to save a shooting victim it was possible to study health care utilization patterns in much the same way assault and crime patterns are tracked. For example, Brenner discovered that across a six-year period, over 900 people in Camden, New Jersey, accounted for over two hundred million dollars in health care expenses. One of these patients had three hundred twenty-four admissions in

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