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All Things HIT

Mar 21 2013   2:32PM GMT

Big Data, retail & marketing: Huge picture for insurers

Posted by: AllinHIT
Big Data, health insurance exchange

There could be something amiss, and some will say right-infringing, concerning information emerging from “Big Data.”

The term Big Data is new but the ability to pull and analyze information from relational databases for the purpose of marketing products and learning about targets within those markets is not.  Using the term Big Data has played a major role in the four Ps of retail marketing – price, product, place and promotion – influencing go-to-market plans and strategies.  Retail organizations will purchase information about their market and targeted individuals’ buying habits from particular marketing firms, seeking answers to questions about consumers like, where do they shop? What do they buy? Now some employers and/or insurers are buying this same information, integrating it with their own Big Data and thus allowing employers and/or insurers to get a “bigger picture” of your health. This includes, more particularly, your eating habits.

Of course, integrating retail Big Data to formulate a “big picture” of one’s health by employers/insurers is in the name of “helping” the members.  Case in point: Blue Cross and Blue Shield of North Carolina recently bought data on 3 million  people in their employers’ plan. If Mary is a BCBS of NC member and purchases clothing from the plus-size store Lane Bryant, this information could indicate that Mary is obese.  Combine this information with recent claims and medications for Mary, and they can develop a specialized care plan with incentives for Mary to lose weight. Hence, making Mary healthier, reducing her dependency on medications, and benefiting from the snowball effect of reducing cost.  I can also envision Mary having access to their telehealth solution, OnlineCareNC.  This service will allow her to receive consultation from coaches and nutritionists through video, secure text chat, or phone.

As you can imagine, there are concerns from privacy pundits of abusing this data.  These concerns surfaced this week with CVS’s announcement that employees have to report their weight and other vitals or face a $600 penalty. I believe something must be done about the rising cost of healthcare as it relates to preventable conditions.  If you decide to be obese, hence more prone to diabetes, CHF, etc., then you should pay more for insurance.  I believe the insurer/employer should give you every opportunity to change, and should give you the incentive to do so.

I know there are many side problems that arise from using  Big Data in the way described here and I wish I had all the answers.  However, as technologists, it is important that we are part of the solution assisting with lowering the cost of healthcare and protecting patient rights.  I don’t think being on the sidelines is the answer if you truly care, which I do!

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