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DataAnalyticsinHealthcareHowAccordionhasbeenhelpingtheindustry

YubinPark,PhD

AccordionHealth• Foundedin2014by

– Sriram Vishwanath,PhD– YubinPark,PhD– JoyceHo,PhD

• Ateamofdata scientistsandmedicalprofessionals

• Wehelphealthcareorganizationssmoothlytransitionfromtheoldfee-for-service systemtoanewvalue-basedreimbursement system

• LocatedinAustin,TX• Website:https://accordionhealth.com

USHealthcareisExtremelyComplex• Medicare• Medicaid• IPA• Hospitals• NursingHomes• Pharmacies• Pharmaceutical

companies• DeviceManufacturers• PrivateInsurers• Employers• …

• Source:https://newrepublic.com/article/63298/your-health-care-system-map

WideSpectrumofApplications• Management/OperationSupport– AutomatedPrior-AuthorizationforPrescriptionDrugandSurgery

– Fraud,Waste,andAbuseDetection– CostandQualityOptimization*

• ClinicalDecisionSupport– MedicalImagingAnalysis– DiagnosisPrediction– ICUEarlyWarningSystem– Precision(orPersonalized)MedicineusingGenomicData

FeeForService(FFS)à

Value-BasedReimbursement(VBR)

Realigningincentivesforprovidersandpayers

FFSà VBR“Thisantiquatedmodel(FFS)istheculpritbehindexponential

health-carecostgrowth.” - TheAtlantic

UnderFFS,- Provider:Moreservices,morereimbursements- Payer: Higherexpensesthisyear,higherpremiumsnextyear- Patient: Constantlyrisinghealthcarecosts

SoftwareCompanyAnalogyIwanttohireaniPhoneappdeveloper. Iwantto postajob

descriptionwithcompensationdetails.

Myoptionsare:- Pay by hour?- Paybythenumberlinesofthecode?- Paywhentheappiscompleted- Payabasewhentheappiscompleted,andabonuswhentheappisdownloaded10,000times- Pay abasewhentheappiscompleted,andabonuswhentheappisdownloaded10,000times,andapenaltyiftheratingisbelow2starsintheappstore

Value?DataistheKEY

- Risk-adjustedcapitatedratesforMedicareAdvantageplans- StarRatingbonusesandpenaltiesforMedicareAdvantageplans

- SharedsavingsforAccountableCareOrganizations

- Bundledpaymentsforhospitalsystems

- 30-dayreadmission rates- Otherqualitymetrics

Time

Valueismeasuredusing longitudinal patientdata(e.g.claims,ElectronicHealthRecords,prescriptiondata,etc.)

StepsforVBR

QuantifyValue

MeasureValue

PredictValue

OptimizeValue

USHealthcareishere

VBR:BundledPayment• Before(current)

– Hospitalsdosurgeries– SkilledNursingFacilitiestake

careofpatientsafterthesurgeries

– Patientsgothroughdifferentfacilitieswithoutpropercoordination

– Results:Highreadmissionsrates,Over-utilizationofservices,Unhappypatientsandpayers

• After(expected)– Hospitalsdosurgeries,but

theyareaccountablefortheepisodeofcare

– SkilledNursingFacilitiesworktogetherwithhospitalsforbettercare-pathsforpatients

– Patientsgothroughwell-designedcareroutes

– Results:Lowreadmissionrates,optimalresourceutilization

VBR-BP:Care-pathOptimization

VBR-BP:How?

Claims,EHR

CollectData

MachineLearning

AnalyzeLongitudinal

Data

WebInterface

Care-pathDesign

WhichMachineLearningAlgorithms?

• Time-SeriesModelsareUseful– Care-pathoptimizationisnotasinglesnap-shotprocess

• Tree-basedModelsareUseful– Lotsofinteractioneffects

• Deep-learning-basedModelsareUseful– Hierarchicalfeaturerepresentation

VBR:PopulationHealthManagement

• Population-levelView– PrevalenceofChronicConditions– PatientStratification– InterventionStrategies– Toachievebetterqualityandlowercost

VBR-PHM:RiskIdentification• PredictiveIdentification– Identifyingpatientswithcertainconditions• Soundssimple?

– Identifyingpatientswho”may”havecertainconditionsinthefuture

• Intervention– Figuringoutthebestinterventionstrategyforaspecificpopulation

VBR-PHM:How?

Source:http://ihealthtran.com/population-health-management

WhichAnalyticsTechniques?

• DataIntegrationistheKEY• Properdatapreprocessingisveryveryimportant• Identifyingwhat’sactionable/predictable• Object/Data-drivenmachinelearningmodelsaredesired– Itisalwayscase-by-case– Freshfishà Sashimi,Goodbeefà Steak,etc.

FutureofHealthcareData

Analytics

ProviderPayer

Thanks

• Contact:yubin[at]accordionhealth [dot]com