Copyright © 2006 Business Insurance

"Data warehouse to sharpen analytical tools" December 5, 2005

by JOANNE WOJCIK

 

In a rare public/private partnership, SCANA Corp. is working with the University of South Carolina to build a health and disability claims data warehouse that will be used to develop interventions to keep SCANA's workforce healthy and productive.

Chris McSwain, SCANA's director of compensation and benefits, said inspiration for the project came from a program he had read about at Pitney Bowes Inc. in which diabetics received access to free generic medications after data mining showed that many were not following standard treatment protocols.

"That's the sort of key learning that we expect to get from this. data operates in silos. Certain patterns won't be seen until the data is put in one place, such as the state of individual health, risk factors and the claims associated with them," he explained.

"Turning data into knowledge, into information, into action. That's our plan. The next step is to take all the health and productivity-related data and put them in one place. Analysis of the data will tell us where we need to go."

With the University of South Carolina virtually "in our backyard—I can literally throw a rock and hit their campus," Mr. McSwain said, it was only natural that SCANA take advantage of what the school had to offer. He said SCANA will also work with the university to apply for grants to fund much of the research.

The data warehouse is expected to be completed and ready for use during the next cycle of benefit contract negotiations, according to David Hoke, manager, total health and productivity at SCANA and the data warehouse project manager.

"Our goal is to get everything done so that the first quarter of next year we'll have all the data to analyze for the '07 benefit year. Our planning cycle is the first quarter to middle of the second quarter," he explained.

The data warehouse will include all of SCANA's medical and pharmacy claims data, the results of the health risk assessments taken during this year's open enrollment, both occupational and non-occupational disability data and other pertinent information drawn from SCANA's human resource information system.

Special precautions will be taken to ensure the security of the data to prevent violations of the Health Insurance Portability and Accountability Act, according to Mr. Hoke, who has been working closely with SCANA's legal department and information technology security departments on the project.

"The data aggregator that SCANA selects will host the data on their system in a de-identified format," he explained. "We'll run our standard ad hoc and custom reports, but what we really want to do is to take that data in a de-identified format and ship it to the university. That's where it will start to get interesting."

Mr. Hoke explained that the epidemiologists in the university's School of Public Health will use SCANA's data to perform population health analyses much like they traditionally have done using government data, only this time the population will be much smaller.

"They are used to doing analyses using population-wide data sets, but why can't an organization or a company be viewed as a small world unto itself?" he queried.

Some of the information that is culled and analyzed will be used to help shape future benefit plan design, or in negotiations with vendors, such as to develop a specialty provider network for certain conditions found to be prevalent among SCANA's employees, retirees and/or their dependents.

"We may use some of the findings to make changes to how our health risk assessment and wellness programs are designed to build interventions to guide people to disease management," Mr. Hoke continued.

Or if the analysis finds that certain types of claims are occurring in geographic clusters, that information will be used to develop high-performance provider networks in those areas to address those conditions, according to Mr. McSwain.

Other uses may be to change copayment and co-insurance structures to encourage consumerism, Mr. Hoke suggested.

"We might even change some corporate policies," he said. "You've got environmental issues to reckon with, you've got policy issues, you're going to have practical day-to-day issues as well as your vendor issues."

"The idea is to start with an open universe. So many times, we put barriers on ourselves before we start. We want to start with an open universe and see what the options are, and then, based on organizational culture, where we are, what's on our list otherwise, and how this reinforces our other messages, choose those things that we think will have the greatest impact on improving the health of the workforce," Mr. Hoke explained.

© Copyright Business Insurance 2006