Our client is an analytics service provider for the German sickness fund market
Client Business Challenges
Our client provides analytics services for 28 of the top 30 German sickness funds
7 M records in their research database
Complete, representative, approved by authorities
However there are many cost driving rules and subgroups are still undiscovered by commonly used analytic tools
Typical examples of interesting analytical questions in the German sickness fund sector are:
Identification and analysis of non-standard morbidity pattern
Analysis of the potential in regard to root causes of coding errors and management solutions
Setup of typical patient and customer profiles for the forecast of cost developments
Creating measures for securing data quality in regard to the MRSA system
Status analyses and setup of morbidity dependent risk groups
Identification, analysis and validation of care strategies and concepts
Measurement approaches on the results of healthcare programmes and schemes
BearingPoint’s Contribution
As a starting point in using the data with HyperCube we designed a specific research question to identify subgroups and significant rules with at least 90% and 95% probability of hospitalisation within one year among patients with congestive heart failure diagnosis
The research question was addressed with the following sample:
Sample of 10,000 cases analysed
Output / dependent variable: Occurrence of a hospital stay among patients with Congestive Heart Failure
Independent variables = age, gender, > 200 variables with binary classifications of reported illnesses, > 200 variables with binary classification of medical drug treatments, some aggregates variables
Client Business Outcomes
All HyperCube findings are supported by advanced clinical and medical studies, verified in the aggregated data of the client
Subgroup discovery and rules identification with HyperCube can bring interesting results on sickness fund data, that go beyond the outcomes of GKV standard tools (e.g. SPSS, Risk KV etc.) due to real service gaps
The identified patterns show huge potential for further analysis in two regards
Application of the analytic approach to further specific diagnoses and drug treatment patterns
Incorporation of further variables to the models – e.g. geographical information, socio-demographic data
Rules identified using the project approach can potentially be used by the GKV, for example, to
strengthen disease and health management
optimise care management
strengthen their position in the dialogue with health service providers