Innovative use of causal artificial intelligence to reveal the practices of medicine that drive improved health outcomes at lower costs
MILWAUKEE and CAMBRIDGE, Mass., May 29, 2019 — The Business Health Care Group (BHCG), a coalition of employers located in Wisconsin covering 200,000 lives, has partnered with GNS Healthcare (GNS), a leading precision medicine company, to discover best practices of health care to improve outcomes and lower the cost of care.
In 2017, U.S. healthcare costs grew to 17.9 percent of the country’s GDP or $3.65 trillion. And yet despite spending more than other countries, health outcomes in the U.S. lag behind other countries across many categories. One of the primary drivers is variation in medical practice among providers that influences health outcomes and the total cost of care. Until now it has not been technically feasible to unravel the subtle and multi-factorial drivers of this variation.
BHCG and GNS are undertaking this study to answer two straightforward questions, “Which doctors return patients to their optimal health status as quickly and efficiently as they can and how do they achieve these results using the most appropriate resources possible?” To perform this analysis, GNS will leverage its powerful artificial intelligence (AI) and simulation computer technology, REFS™ (Reverse Engineering & Forward Simulation) to evaluate the current health care provided to Wisconsin citizens. They then apply “what if?” changes to reveal the combination of patient care factors that drive health outcomes and costs.
The claims information for this evaluation will be provided by the Wisconsin Health Information Organization (WHIO) and includes 4 million insured individuals or 70% of Wisconsin’s population. The WHIO information (de-identified so that individual patients cannot be recognized) tracks an entire episode of care from start to finish and identifies the best results achieved by doctors across the state. This information can then be used to improve practice patterns and get patients to the most effective providers.
“These insights have the potential to dramatically improve health outcomes, identify care that does not improve patient’s lives and reduce health care spending on services that don’t improve a patient’s condition. What excites us about this partnership is the fact that GNS is a leader in health care AI technology for pharmaceutical companies, health plans, providers and patient organizations, and is now extending this technology to self-funded employers. Their technology will allow us to understand how and where the best care is delivered so that we can continue our mission of improving the value of health care provided in Wisconsin and beyond,” said Jeffrey Kluever, executive director of BHCG.
“We believe this initiative holds the potential to influence a substantial leap in the overall value of care that will benefit all health care stakeholders – employers, insurers, health systems, providers and, most importantly, employees, dependents and our communities,” Kluever added.
Said Colin Hill, chairman, CEO and co-founder of GNS. “This is a natural extension of the work GNS has been doing to leverage machine learning across the health care ecosystem to slow disease progression, improve health outcomes and lower costs by matching the right treatment to the right person at the right time. By making this technology available to self-funded employers who pay for the bulk of health care costs and, in turn, to health care providers who deliver care, we are able to convey insights and value on a large scale. Having an innovative partner like BHCG means that those insights will be turned into real, productive change for the employers who are part of BHCG.”
About Business Health Care Group
Business Health Care Group leverages member employer purchasing power and knowledge to lead change. The organization creates value through innovative, shared strategies to improve health care quality and cost efficiency for employers, employees and the community. BHCG membership exceeds 200,000 covered lives in the 22-county region of eastern Wisconsin. Visit BHCGWI.org to learn more.
About GNS Healthcare
GNS Healthcare solves healthcare’s matching problem for leading health plans, biopharma companies, and health systems. We transform massive and diverse data streams to precisely match therapeutics, procedures, and care management interventions to individuals, improving health outcomes and saving billions of dollars. Our causal learning and simulation platform, REFS, accelerates the discovery of what works for whom and why. www.gnshealthcare.com
REFS™ (Reverse Engineering & Forward Simulation) is GNS Healthcare’s patented causal learning and simulation platform. Unlike traditional artificial intelligence platforms, REFS analyzes data sets beyond correlation, instead inferring causal mechanisms between variables to answer questions such as: How will the patient respond to this treatment? What if we choose one intervention over another? REFS is the only commercially available platform that infers causal mechanisms from patient data at scale from traditional health care and emerging data sources to bring the promise of precision medicine within reach.
About Wisconsin Health Information Organization
Wisconsin Health Information Organization’s (WHIO) mission is to improve the quality, safety and cost effectiveness of the health care in Wisconsin. The WHIO’s data, analytics and reporting services are used by associations, provider systems, health plans, employer coalitions, state government and others for strategic and operational planning and to identify best care practices. The WHIO is Wisconsin’s largest source of data and information and includes 4 million insured lives and $100 billion of health care services across the continuum of care. www.wisconsinhealthinfo.org
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Michael or Mary Rode
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