NEW YORK – A study of the prevalence of conditions in the U.S. employer-insured population provides a glimpse of the capabilities of large-scale analysis of claims databases with de-identified records of millions of individuals.
The study, using the MarketScan databases of Thomson Reuters, sought to use extensive claims data to estimate prevalence rates and costs for specific diagnosed conditions among 175 million Americans covered by employer-sponsored insurance.
The study found that congestive heart failure had the highest projected annual expenses among those covered by employer-sponsored insurance, with costs estimated at $29,930 annually (see box for other conditions and associated costs).
Because of the size of the database, the study was able to look at prevalence rates among age groups, gender, regions and types of plan coverage.
Thomson Reuters was able to use a weighting methodology to take the data in its claims database and make it representative of a larger population, in this case that of employer-sponsored insurance, said Leigh Hansen, the company’s strategic marketing director and lead author on the study.
“This is a payer population that has good healthcare coverage, and it’s a large group with fewer cost barriers to care,” Hansen said. “By coupling probability samples with the large sample size of the claims database, it makes the projections more reliable.”
Results of this study could help payers, health plans and employers to be able to understand the prevalence of disease among segments of their population, and it can help them make educated decisions on disease management.
Analyzing the data, for example, might be able to determine whether congestive heart failure patients, as a whole, were filling prescriptions and receiving care to mitigate the serious, expensive aspects of their disease.
“We can look for opportunities for improving financial and patient medical outcomes,” Hansen said.
The database and related tools can easily and quickly sort through data to find results that can affect care delivery, she added.
“Being able to get this information easily is the wave of the future,” she said. “It helps turn the data into information that’s actionable by a practitioner.”
Will greater insights into the prevalence of conditions lead to better disease management initiatives? Tell us what you think – email your views to editor@healthcarefinancenews.com.