SYSTEM AND METHOD FOR PREDICTIVE MODELING DRIVEN BEHAVIORAL HEALTH CARE MANAGEMENT
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United States of America Patent
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app pub date -
Jan 22, 2007
filing date -
Jan 22, 2007
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Abstract
A system and method for administering reductions in future behavioral health care costs through interventions in an insurance plan participant's behavioral health regimen, is disclosed. Information is processed and provided to case managers and/or health care providers in a manner than significantly improves the ability of such individuals to selectively identify plan participants that are most likely to benefit from the intervention. A database is built from a larger set of insurance data, and this data is then further processed to generate, based at least in part on clinical data derived from medical and pharmacy claims, a predictive model that is used to predict the likelihood of future utilization of behavioral health services by a plan participant. The prediction results indicate the relative desirability of intervention in the participant's behavioral health regimen and are used to guide the case, disease, and behavioral health services utilization management for all plan participants.
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