Advanced Analytics Drives Blue Cross Health Care Solutions

Blues Perspectives

| 3 min read

What if you could go to work every day knowing that you’re helping make the health care system better for patients? And that the work that you do will lead to lower health care costs and better health outcomes?
At Blue Cross Blue Shield of Michigan, the team in the Analytics Center of Excellence works to do just that.
“We use data and analytics to help identify ways people can have better quality outcomes and better experience through the health care system – that should lead to lower cost and premiums for our members,” said Alan Huddy, vice president of the Analytics Center of Excellence at Blue Cross.
The Analytics Center of Excellence produces data and analytics that drive solutions to improve the health of Blue Cross members. This involves a team approach within the Analytics Center of Excellence. There are three major roles on the team:
  • Advanced analytics: Individuals with data science and analytics engineering expertise use data to solve complex problems. They build models using advanced analytic techniques (artificial intelligence and machine learning) to help predict which members are at risk for certain health events or conditions. For example, these models could help predict which members are at risk for a hospital readmission – information used by other teams within Blue Cross to facilitate care management and outreach.
  • Analytics enablement: This part of the team builds pipelines for data and analytics so that they can be consumed by other business areas. This includes data architecture, which is formatting large sets of data so that it can be analyzed quickly, efficiently and uniformly across the company.
  • Consultative: Individuals on this part of the team act as a liaison between the technical teams doing analytics work and other areas of the business. They organize projects and coordinate work efforts, translating the needs of the business to the technical applications needed by the analytics teams.
The goal of advanced analytics within Blue Cross is to help members improve their overall health by using targeted education and prevention measures. The added benefit of improved health outcomes is decreased health care costs for members and the system. The data models produced by the team can be used to implement vendor solutions or can be used to craft new strategies and approaches.
“Our team is building out enterprise assets to help the business transform how they use data and analytics. We’re not just developing models for specific cases. We’re involved in an enterprise-wide transformation about how we perform analytics and support the business,” Huddy said.
For example, data modeling can be used to help identify members at risk of readmission to the hospital within 30 days or 60 days of a procedure. In turn, proactive care management strategies can be used to help prevent those members from a costly readmission and adverse health impacts. This approach is one example of how Blue Cross has quickly adapted to the rapid development of technology in health care to help members.
“We’re best in class among Blues plans in our ability to use data to solve complex problems,” Huddy said.
The Analytics Center of Excellence includes professionals with backgrounds in insurance and beyond, including retail sales and health care. The department continues to grow and is always looking for talented individuals to join the team. If you’re interested in joining the team at Blue Cross, here are our open positions. 
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association