While payers have traditionally used health claims to predict illness and mortalities, they are now mining data collected from electronic health records to try to intervene and steer consumers to a healthier lifestyle. Aetna is one such payer, according to a Politico report.
Similar to recent reports regarding providers like Charlotte, N.C.-based Carolinas HealthCare System accessing information from data brokers to identify potentially high-risk patients by examining their spending habits, payers such as Aetna are analyzing healthcare data from EHRs and encouraging "their sickest, most expensive" consumers to start leading a healthier lifestyle, according to the report.
Researchers used claims data and EHRs to predict which employees at a multinational corporation ensured by Aetna would develop diabetes-related problems within one year, and their predictions were almost always correct, according to the report.
Much of this activity surrounding electronic data mining is spurred by meaningful use incentives as well as cutting down costs payers have to cover for patients. According to the report, an employer pays on average annual claims of $3,400 for a healthy employee and $10,000 for a diabetic employee.
Insurers and employers are offering wellness programs and other incentives such as annual premium credits for undergoing screening tests and participating in wellness programs, all to help employees and consumers become healthier and, in turn, reduce the cost to cover their healthcare.
However, as is to be expected, some are concerned with the ethics of the practice. Arthur Caplan, a bioethicist at New York University, said in the report that when such programs become mandatory, they toe an ethical line.
"Sure, health is good and healthy workers are good for business, but letting your boss and his hired agent impose their values on your personal lifestyle and choices seems coercive and intrusive," Mr. Caplan said in the report.
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