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What big health insurers are doing with big data

Insurance companies like Kaiser, Aetna, Anthem and UnitedHealth have been making big data pays

Financial trends and news by Steven Loeb
November 6, 2018
Short URL: http://vator.tv/n/4c94

When Vator and HP held the SplashX Invent Health - Precision Health salon at the end of September, one of the things that came up repeatedly was how big data was changing healthcare from every perspective, from the doctor to the patient to the entrepreneur. Big data is fueling everything from precision medicine to technologies like artificial intelligence and machine learning.

You can't talk about healthcare in the U.S., though, without mentioning the insurance companies. They are an integral part of the system. So it's no surprise that they too are starting to use big data to change how they operate and how they offer services. 

It also happens to be earnings season, and the health insurance companies are all seeing big gains in their stocks this year. Anthem beat its earnings last week and is up 20 percent year-to-date, while UnitedHealth is up 19.5 percent. Kaiser Permanente posted its earnings earlier this week, and saw double-digit growth

Humana, meanwhile, is reporting earnings on Wednesday, and is expected to see EPS of $4.26, and sales of $13.98 billion.

As big data and artificial intelligence take root in the healthcare space, these types of initiatives are something analysts will be wanting to know more about, especially as revenue from these technologies continue to climb. 

Here's some of the initiatives that the big insurers have put in place using big data:

Anthem

Anthem, which recently began building out its AI team with the hire of former Googler Udi Manber to lead its AI group, has a subsidiary called HealthCore, which acts as its health outcomes research arm. HealthCore has information on almost 60 million individuals in the U.S. and uses that to give healthcare decision makers actionable intelligence. 

In May, HealthCore partnered with Boston Health Economics’ Instant Health Data platform, allowing direct access to its Integrated Research Database for the first time. 

Anthem is the third largest healthcare insurance company in the country, covering 40 million people or 6.2 percent of the market.

UnitedHealth Group

UnitedHealth has also made strides in artificial intelligence. Optum, the health services arm of UnitedHealth Group, plans to use AI to predict who will develop atrial fibrillation, as well as other diseases. Optum even opened its own $250 million AI fund in 2017. 

One of its services is OptumIQ which "represents our unique combination of data, analytics and health care expertise. Infused into our solutions, OptumIQ helps clients measurably improve outcomes, better manage cost and improve access to appropriate care and therapies," the company writes. It has more than 24,000 data and analytics experts working on healthcare. 

The company also offers OptumInsights, which leverages the company's data and analytics capabilities. In Q3 2018, this arm took in $2.3 billion for UnitedHealth, with growth of 12.5 percent year-to-year.

(Note: This group's Chief Health Officer Seth Serxner will be speaking at our next SplashX Invent Health salon focused on lifestyle medicine. Join us on 12/13 at HP headquarters in Palo Alto for HP and Vator's "Vitality: Lifestyle as a drug.")

UnitedHealth Group, which covers nearly 13 percent of the healthcare market, has a network size of 859,890 health care professionals. It is the largest insurer in the U.S.

Kaiser Permanente

Kaiser founded the Center for Health Research in the 1960s, which powers its Research Data & Analysis Center, Research Data Warehouse, and Virtual Data Warehouse, as well as the work being done by its Predictive Analytics Unit.

"Through our relationship with Kaiser Permanente, we have access to the largest non-governmental electronic health record system in the world. This allows us to follow our study populations for years—even decades—and develop new tools for predicting which patients will benefit the most from health care interventions," the organization says.

It has 41 investigators, 243 staff members, and annual revenues of nearly $45 million.

The company has also leveraged its big data capabilities into artificial intelligence. 

Earlier this year, Kaiser Permanente teamed with Medial EarlySign, a provider of machine-learning based solutions to improve non-communicable disease management, to help develop its AlgoAnalyzer platform which can identify patients who might need interventions. And the company's venture arm, Kaiser Permanente Ventures, has invested in AI healthcare companies that include Ginger.io, Proteus Digital Health and Big Health.

Kaiser is the second largest insurer in the U.S. with 7.5 percent of the healthcare market.

Humana 

Humana, which is the fifth largest insurer with 5.5 percent of the healthcare market, announced in August that it would be establishing a center for digital health and analytics, to be known as Humana Studio H, in Boston. It expects to employ as many as 250 people and it named Heather Cox as Chief Digital Health and Analytics Officer.

“The technology is absolutely crucial in order for there to be an improvement in quality,” Roy Beveridge, MD, chief medical officer at Humana, said in an interview. “Unless you arm the physician with good data in a format that they can work with and understand, they’re not going to be successful.”

Aetna

Aetna covers 5.6 percent of the healthcare market, making it the fourth largest insurer. 

In December of last year, it was announced that Aetna would be purchased by CVS Health for $69 billion, specifically for its analytics and data.

For example, CVS said it would use the data to help patients avoid unnecessary hospital readmission by giving patients a review of their medications after they are discharged from the hospital, as well as home devices to monitor things like activity levels, pulse, and respiratory rates.

"With the analytics of Aetna and CVS Health's human touch, we will create a health care platform built around individuals. We look forward to working with the talented people at Aetna to position the combined company as America's front door to quality health care, integrating more closely the work of doctors, pharmacists, other health care professionals and health benefits companies to create a platform that is easier to use and less expensive for consumers," it said in the press release. 

The deal is reportedly going to close by Thanksgiving of this year. 

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