Prescription Data-Mines and Insurance “Credit-Reports”

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The End to “Rx” Privacy? 

[By Staff Reporters}

Collecting and analyzing [HIPAA protected?] personal health information [PHI] in commercial databases is a fledgling, but exploding industry, despite privacy concerns.

Industry Leaders

For example, Milliman’s IntelliScript provides personal drug profiles to insurers. And, Ingenix’s MedPoint is owned by UnitedHealth, the corporation that owns UnitedHealthCare. UHC is also the nation’s second-largest health insurance company.

Large Data Bases

Both firms created their large profiles by mining rich databases of prescription drug histories [eRXs], kept by pharmacy benefit managers [PBMs], which help insurer’s process drug claims. The data-base then aggregates and ranks the information, based on the drugs and dosages, dates filled and refilled, therapeutic class, and the name and address of prescribing doctor; etc. Higher scores imply higher health insurance premium costs.

Thus, prescription data is used to “rate” or economically judge potential insured patients via these “health credit-reports.”

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matrix pills

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Assessment

And so, while politician’s debate how to regulate electronic medical records [EMRs], and attorneys monitor HIPAA policies, some health insurers have already begun tapping into other information sources such as clinical and pathological laboratories, as well. And, other sources are sure to follow.

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

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Improving Inter/Intra Professional Relations

Establishing Rapport within the Medical Community

By Dr. David Edward Marcinko; MBA, CMP™

Publisher-in-Chief

By Hope Rachel Hetico; RN, MHA, CMP™

Managing Editor

In our consulting work, publishing, speaking engagements and relate professional endeavors, we are often asked how to establish and even increase professional visibility in a particular medical, or even alternative-medial community.

While there is no-one-size-fits-all answer, the following are useful “tips and pearls” to enhance your awareness among known, and unknown, physician colleagues in your geographic locale.

A Few “Tips and Pearls”

  • Send office announcements to all health professionals in the community. Include pharmacies, pediatricians, family practitioners, PAs and NPs, concierge practices, chiropractors and alternative medical provides, convenient-care and convalescent facilities. All are potential sources of patient referrals.
  • Meet other health professionals personally and establish a one-to-one relationship with them. This will serve to educate them to your abilities and practice.
  • Send written reports to all practitioners who refer patients.
  • Do not hesitate to refer patients for consultations, as indicated. This is not only good business sense, but good medicine.
  • Use novel business cards, such as the new CD-ROMs cut into the size of a standard business card, by One Voice Technologies, of San Diego. For about a dollar, depending upon quantity, you can order a labeled disc with all the business information of a standard card, which also functions as a CD-ROM containing up to 100 megabytes of multi-media data about your medical practice or specialty.

Assessment

Please feel free to send in your own “tips” and favorite professional relationship building ideas.

Conclusion

What differentiates you from the competition, and how did you become know in your local medical community; please opine and comment?

Related Information Sources:

Practice Management: http://www.springerpub.com/prod.aspx?prod_id=23759

Physician Financial Planning: http://www.jbpub.com/catalog/0763745790

Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com  or Bio: www.stpub.com/pubs/authors/MARCINKO.htm

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