BHCG, GNS Healthcare partner to discover best practices

The Business Health Care Group (BHCG), a coalition ofemployers located in Wisconsin covering 200,000 lives, has partnered with GNSHealthcare (GNS) to discover best practices of health care to improve outcomesand lower the cost of care.

In 2017, U.S. healthcare costs grew to 17.9 percent of thecountry’s GDP or $3.65-trillion. And yet despite spending more than othercountries, health outcomes in the U.S. lag behind other countries across manycategories. One of the primary drivers is variation in medical practice amongproviders that influences health outcomes and the total cost of care. Until nowit has not been technically feasible to unravel the subtle and multi-factorialdrivers of this variation.

BHCG and GNS are undertaking this study to answer two straightforwardquestions, “Which doctors return patients to their optimal health status asquickly and efficiently as they can and how do they achieve these results usingthe most appropriate resources possible?” To perform this analysis, GNS willleverage its artificial intelligence (AI) and simulation computer technology,REFS (Reverse Engineering & Forward Simulation) to evaluate the currenthealth care provided to Wisconsin citizens. They then apply “what if?” changesto reveal the combination of patient care factors that drive health outcomesand costs.

The claims information for this evaluation will be providedby the Wisconsin Health Information Organization (WHIO) and includes 4 millioninsured individuals or 70 percent of Wisconsin’s population. The WHIOinformation (de-identified so that individual patients cannot be recognized)tracks an entire episode of care from start to finish and identifies the bestresults achieved by doctors across the state. This information can then be usedto improve practice patterns and get patients to the most effective providers.

“These insights have the potential to dramatically improvehealth outcomes, identify care that does not improve patient’s lives and reducehealth care spending on services that don’t improve a patient’s condition. Theirtechnology will allow us to understand how and where the best care is deliveredso that we can continue our mission of improving the value of health careprovided in Wisconsin and beyond,” said Jeffrey Kluever, executive director ofBHCG.

“We believe this initiative holds the potential to influencea substantial leap in the overall value of care that will benefit all healthcare stakeholders – employers, insurers, health systems, providers and, mostimportantly, employees, dependents and our communities,” Kluever added.

Colin Hill, chairman, CEO and co-founder of GNS said: “Thisis a natural extension of the work GNS has been doing to leverage machinelearning across the health care ecosystem to slow disease progression, improvehealth outcomes and lower costs by matching the right treatment to the rightperson at the right time. By making this technology available to self-fundedemployers who pay for the bulk of health care costs and, in turn, to healthcare providers who deliver care, we are able to convey insights and value on alarge scale. Having an innovative partner like BHCG means that those insightswill be turned into real, productive change for the employers who are part ofBHCG.”