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A predictive modeling approach to increasing the economic effectiveness of disease management programs

  • Predictive Modeling (PM) techniques are gaining importance in the worldwide health insurance business. Modern PM methods are used for customer relationship management, risk evaluation or medical management. This article illustrates a PM approach that enables the economic potential of (cost-)effective disease management programs (DMPs) to be fully exploited by optimized candidate selection as an example of successful data-driven business management. The approach is based on a Generalized Linear Model (GLM) that is easy to apply for health insurance companies. By means of a small portfolio from an emerging country, we show that our GLM approach is stable compared to more sophisticated regression techniques in spite of the difficult data environment. Additionally, we demonstrate for this example of a setting that our model can compete with the expensive solutions offered by professional PM vendors and outperforms non-predictive standard approaches for DMP selection commonly used in the market.

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Metadaten
Author:Andreas Bayerstadler, Franz Benstetter, Christian Heumann, Fabian Winter
URL:https://doi.org/10.1007/s10729-013-9246-y
Parent Title (English):Health Care Management Science
Document Type:Article (peer reviewed)
Language:English
Publication Year:2014
Tag:Comparison of methods; Generalized linear model; Health insurance; Predictive modeling; Selection for disease management programs
Volume:17
First Page:284
Last Page:301
Peer reviewed:Ja
faculties / departments:Fakultät für Angewandte Gesundheits- und Sozialwissenschaften