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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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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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Filed under: Health Insurance, Health Law & Policy, Information Technology, Risk Management | Tagged: credit reports, HIPAA, PBMs, PHI, prescription privacy |
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More on Credit Scores
http://www.infographicsarchive.com/business-economics/all-you-need-to-know-about-credit-scores/
Gina
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Prescription Drugs Driving 4% Increase in Health Spending
According to the Altarum Institute:
• Health spending in July 2014 grew 4.3% over July 2013. Year to-date up 4.4%
• Health spending well above 3.6% growth rate estimated for 2013 by CMMS.
• Spending on prescription drugs grew by 11% in July.
• Growth in spending on health care services has remained under 4%.
Note: These data come from the monthly Health Sector Economic IndicatorsSM briefs released by Altarum Institute’s Center for Sustainable Health Spending (www.altarum.org/HealthIndicators).
Source: Altarum Institute
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