Abstract: According to one aspect of the invention, health insurance claim data for a first group of individuals is obtained to generate a training corpus, including a training set of claim data and a holdout set of claim data. The first group of individuals represents enrollees of one or more first health insurance plans and the health insurance claim data represents historic insurance claim information for each individual in the first group. A Bayesian belief network (BBN) model is created by training a BBN network based on the training set of claim data using predetermined machine learning algorithms. The BBN model is validated using the holdout set of claim data. The BBN model, when having been successfully validated, is configured to identify at least one of individuals with risk for a disorder and individuals with risk who are most likely to benefit from intervention and treatment for the disorder.
Type:
Application
Filed:
September 30, 2010
Publication date:
April 7, 2011
Applicant:
DecisionQ Corporation
Inventors:
John S. Eberhardt, III, Philip M. Kalina, Todd A. Radano