Assume that populations covered by the employer in the data are similar to the population

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ANSWER ALL QUESTIONS

Predictive Analytics in Health Care

Instructions:. There is no size limit on any single question, but the entire test should be no longer than 4 typed, double spaced pages. Completed exams submitted to ICollege assignment submission folder.

1. In the recent past contract negotiations between Piedmont Hospital and Blue Cross broke down and Piedmont was removed from Blue Cross’s networks.  A proposal was made to allow state employees affected by moving Piedmont out of network to switch health insurance plans to one that keeps Piedmont in network. 

• (Pretend) You are an analyst for another insurance company that has Piedmont in your network.  You have claims data from another city where a large employer allowed employees to switch plans when a major hospital became out of network during contract negotiations. The data shows expenditures per enrollee from the prior year and whether the enrollee switched plans to one that retained the hospital in network.

Assume that populations covered by the employer in the data are similar to the population in Atlanta and that costs are also similar. Using data contained in the EXCEL spreadsheet Switch Data Question 1 and the data dictionary in Claims Data dictionary to estimate the effect on your plan’s claims cost of people who may switch to your plan.*

Write a short memo describing your estimate, and your confidence in that estimate. 

*This data is entirely made up and any resemblance to any health plan living or dead is purely coincidental.  

2. Skim the paper contained in the PDF file TraumaOwnership. Use the regressions described in Table 2 on Page 43 to describe the effect of being uninsured on for those with injuries and the variation in hospitalization rates across injury severity levels for the uninsured.

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