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Sample HSI Software Projects

Title: Using the Johns Hopkins Ambulatory Care Groups to Generate a Case-mix Adjusted Specialist Profiling System

Client: Blue Cross Blue Shield of the Rochester Area

HSI adapted the Johns Hopkins University Ambulatory Case Group Case-mix Adjustment to be used in specialist profiling based on administrative claims data. The final software developed for the project combined an innovative multivariate statistical model with the ACG case-mix grouping to generate a profiling system producing R-square values in excess of 0.6. The profiling system was used by Blue Choice in Rochester, New York to re-focus their utilization management activities and account for significant differences in specialist case-mix.

Title: Generating a C-Section Provider Profiling System

Client: Finger Lakes Blue Cross Blue Shield

Working with the Finger Lakes Blue Cross Blue Shield plan in New York, HSI developed a sophisticated episode of care model to measure a mother's utilization from prenatal to postnatal care. The episode of care algorithm was enhanced and translated in a Windows-based application that provided C-section profiles to all delivering providers across all lines of business at Finger Lakes Blue Cross Blue Shield.

Title: The Physician Utilization managed Advisor Software Initiative (PUMA)

Client: The Delmarva Foundation for Medical Care

HSI provided project management services for the PUMA initiative, sponsored by the Delmarva Foundation for Medical Care. The objective of the project was to develop a provider profiling prototype that would permit the interactive development of an episode of care. Additional features, such as an episode of care generator, and interactive context-sensitive links to the Internet were developed conceptually for market analysis and prototype revisions/enhancement.