{"title":"利用预测分析技术,有针对性地采取由支付方主导的坚持用药干预措施。","authors":"Pankhuri Sharma","doi":"10.37765/ajmc.2024.89610","DOIUrl":null,"url":null,"abstract":"<p><p>This article examines how predictive analytics can enhance payer initiatives to improve medication adherence. Despite its known impact on health outcomes and costs, medication nonadherence remains a widespread and persistent challenge in health care. Although payers are increasingly involved in addressing nonadherence, traditional approaches typically lead to suboptimal results due to their reactive nature and generic intervention. With improved access to data and more sophisticated machine learning tools, there is a growing opportunity for payers to use predictive analytics to stratify and target members at high risk, predict potential primary and secondary nonadherence, and preemptively intervene with tailored solutions. The potential benefit of this approach includes prevention, not only resolution, of nonadherence and leads to improved health outcomes, reduced health care costs, and increased member satisfaction. The article also discusses potential caveats to consider, such as data sharing, bias mitigation, and regulatory compliance, when implementing predictive analytics in this context.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Leveraging predictive analytics to target payer-led medication adherence interventions.\",\"authors\":\"Pankhuri Sharma\",\"doi\":\"10.37765/ajmc.2024.89610\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>This article examines how predictive analytics can enhance payer initiatives to improve medication adherence. Despite its known impact on health outcomes and costs, medication nonadherence remains a widespread and persistent challenge in health care. Although payers are increasingly involved in addressing nonadherence, traditional approaches typically lead to suboptimal results due to their reactive nature and generic intervention. With improved access to data and more sophisticated machine learning tools, there is a growing opportunity for payers to use predictive analytics to stratify and target members at high risk, predict potential primary and secondary nonadherence, and preemptively intervene with tailored solutions. The potential benefit of this approach includes prevention, not only resolution, of nonadherence and leads to improved health outcomes, reduced health care costs, and increased member satisfaction. The article also discusses potential caveats to consider, such as data sharing, bias mitigation, and regulatory compliance, when implementing predictive analytics in this context.</p>\",\"PeriodicalId\":50808,\"journal\":{\"name\":\"American Journal of Managed Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Managed Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.37765/ajmc.2024.89610\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Managed Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.37765/ajmc.2024.89610","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Leveraging predictive analytics to target payer-led medication adherence interventions.
This article examines how predictive analytics can enhance payer initiatives to improve medication adherence. Despite its known impact on health outcomes and costs, medication nonadherence remains a widespread and persistent challenge in health care. Although payers are increasingly involved in addressing nonadherence, traditional approaches typically lead to suboptimal results due to their reactive nature and generic intervention. With improved access to data and more sophisticated machine learning tools, there is a growing opportunity for payers to use predictive analytics to stratify and target members at high risk, predict potential primary and secondary nonadherence, and preemptively intervene with tailored solutions. The potential benefit of this approach includes prevention, not only resolution, of nonadherence and leads to improved health outcomes, reduced health care costs, and increased member satisfaction. The article also discusses potential caveats to consider, such as data sharing, bias mitigation, and regulatory compliance, when implementing predictive analytics in this context.
期刊介绍:
The American Journal of Managed Care is an independent, peer-reviewed publication dedicated to disseminating clinical information to managed care physicians, clinical decision makers, and other healthcare professionals. Its aim is to stimulate scientific communication in the ever-evolving field of managed care. The American Journal of Managed Care addresses a broad range of issues relevant to clinical decision making in a cost-constrained environment and examines the impact of clinical, management, and policy interventions and programs on healthcare and economic outcomes.