2011 Predictive Modeling Priorities

by Clive Riddle, May 12, 2011

The Predictive Modeling Web Summit and Predictive Modeling News jointly sponsored a survey of health plan and healthcare professionals conducted by MCOL on “Prioritizing Predictive Modeling Activities.” Participants typically have a more active interest in predictive modeling. This survey has been previously conducted since 2008, allowing the current results to be compared to previous responses.

Participants were asked to respond to two items:

1. Please categorize your organization.
2. Suppose you had to prioritize how an organization could spend its funds on predictive modeling initiatives involving health benefits, and you were given a list of 10 items to prioritize. How would you rank them? (1= highest priority / 10 = lowest priority; rank them 1 through 10).

The items to rank were as follows, with their abbreviated version, referred to subsequently, indicated in parentheses: 

• Identification of High-Risk Patients for Care Management (Identify)
• Plan Design Development (Design)
• Fraud Prevention (Fraud)
• Treatment Guideline Development (Guideline)
• Provider Profiling for Network Development (Profiling)
• Provider Payment Rate and Restructuring (Payment) *[worded differently in previous years]
• Premium Rate Development (Premium)
• Medicare / Medicaid Population Financial Modeling (Medicare)
• Target Marketing Based on Customer / Prospect Risk Scores (Marketing)
• Formulary Development (Formulary)

Here’s what the survey found:

• In 2011, 56.8% of respondents listed Indentify as their number one priority, compared to 51.5% in 2008
• For 2008 through 2011, while there was variation by respondent category for all other items, Identification of High-Risk Patients had the top average priority ranking, and was the mode for the number one priority with all three categories (payer, provider and vendor).
• The next-highest priority mode in 2011 was Treatment Guideline Development, but by category had a mode of 2 for providers & vendors and a mode of 6 for payers..
• Treatment Guidelines and Provider Profiling had significantly higher priority modes in 2011 than in the past while Target Marketing had a much lower priority mode in 2011 than in past years.

The average ranking by item for this year and in 2008 is as follows:

Item	2011	2008
Identify	2.30	2.54
Guideline	4.25	4.75
Design	4.63	4.25
Profiling	4.84	5.16
Payment*	4.86	5.41
Medicare	4.92	5.71
Marketing	5.26	5.84
Premium	5.87	5.59
Fraud	5.93	N/A
Formulary	6.07	6.35

n= 81 in 2011; 88 in 2008