Newsroom | Collaborative Care

As the new coronavirus began to spread widely in the U.S., a team of data scientists at Health Care Service Corporation began trying to identify potential hotspots and who may be at highest risk for becoming severely ill.

They crunched internal data along with information from external sources, such as community demographics and anonymized mobility patterns published by cell phone providers.    

“Looking at all this information as a whole, we could establish trends,” says Derrick Higgins, a member of the data and analytics solutions team. “My team has benefited tremendously from investments in analytics across the company.”

The predictive analysis helped the company develop initiatives aimed at preventing infection among vulnerable members and communities.   

The Health Advocacy Solutions (HAS) clinical staff — who provide eligible members concierge-like support, including case and clinical management — has used this analysis to reach out to more than 3,000 members identified as higher risk.

HAS nurses who are ordinarily responsible for utilization management pivoted to provide these members with information about the coronavirus, as well as assistance with other needs. They also identified about 250 members who needed case management.

“They wanted to help," says Susan Laski, divisional vice president of Health Advocacy Clinical Solutions.  “Without this outreach, we would not have identified these members as needing additional support and services.” 

Denna Shives, a utilization management coordinator, says the temporary transition gave her the opportunity to directly support members under unprecedented circumstances. A former pediatric nurse, she says the outreach reminded her of the bedside conversations she used to have with patients and families.

“I’ve enjoyed being able to really connect and have wonderful conversations with members,” Shives says. “It was a wonderful way to assist during this time. It’s been a learning and growth opportunity for me.”

This analysis also led HCSC's plan in Oklahoma to partner with the Oklahoma Caring Foundation to support an Oklahoma initiative to test 2% of the state’s population for COVID-19.

This partnership assisted the Oklahoma Department of Health in exceeding its goal to perform nearly 113,300 COVID-19 tests before the end of May. Five Caring Vans were used as testing sites for more than 880 people in underserved parts of Oklahoma, including Native Americans who are at high risk for severe illness.

Native Americans nationwide disproportionately suffer underlying conditions such as diabetes, respiratory ailments and heart disease, which increase their risk.

“The Native American population was a priority for sure in the beginning,” says Patrick Hutton, a value-based health care consultant for the Oklahoma plan. “We really wanted the state to know we're not only looking out for our members, but all Oklahomans. It’s a great feeling to blend public and private entities and discover news ways to innovate. This was one of the ways to show how it’s possible.”