Margins and Paddings Update

Health information security breaches and identity theft have become an epidemic with losses occurring across the country. In fact, according to a recent Ponemon Institute study sponsored by the Medical Identity Fraud Alliance, medical ID theft has increased by 21.7 percent since 2013. Additionally, data from the Department of Health and Human Services indicates that health data on more than 120 million people has been compromised in more than 1,100 separate breaches since 2009. In May 2015, CareFirst BlueCross BlueShield, the largest health insurer in the Mid-Atlantic region, reported a cyber-attack that affected 1.1 million past and present customers. This comes on the heels of the February 2015 data breach at Anthem, the second-largest health insurer in the United States that affected about 80 million customers, and Premera Blue Cross’ reported cyber-attack that may impact as many as 11 million people. These attacks reflect an unsettling pattern in cybercrime as identity thieves expand their target from the financial sector into healthcare.The mere fact that health records are now digital makes them a prime target. Providers have now moved rapidly into the digital space and many don’t deploy the same robust security measures taken by their banking counterparts. Furthermore, patients now have unprecedented access to their health information thanks to the widespread use of patient portals. With providers, payers, pharmacies, labs and patients all having access to sensitive records, information security becomes vulnerable to the weakest link in the data chain. To compound the issue, stolen medical identity information is extremely valuable. While a purloined credit card number might fetch $10 on the black market, a stolen medical identity can bring in more than five times that amount. So, what’s the solution? Other major industries including financial services, telecommunications and insurance have been using Big Data and analytics for years to protect their online portals, minimize risk and reduce fraud losses. When applied in a healthcare setting, it is these same techniques that will enable professionals to gain insights that can be turned into actions to protect patient data. For example, identity-matching tools can confirm whether a patient or a physician is who they claim to be, and analyzing data and usage characteristics can more effectively assess the risk of a patient’s remote interaction. In essence, by utilizing these techniques, data can be a force for good – good for the patient, good for the healthcare provider and good for the industry.

With rising insurance costs, deductibles and copays, some people struggle to afford the out-of-pocket expense that can come with seeking medical treatment. Because of this, some consumers decide not to seek treatment, which could have negative effects on their health and overall well-being. While it’s true healthcare organizations do provide financial assistance and often have charity programs to help offset the costs, most do not have the financial resources to absorb a substantial increase in patient debt that is being driven by consumers selecting high deductible health insurance plans then not being able to pay. The additional challenge is that many hospitals and healthcare providers do not have the means to quickly and accurately determine which patients qualify for charity programs, which are able to pay for care, and which patients need payment plans to help them soften the blow from an unforeseen healthcare event. To help address the problem, Experian provides hospitals, medical offices and clinics with unique data and analytics to provide insight into each patient’s financial situation. By leveraging healthcare-specific predictive models, Experian enables healthcare organizations to easily and efficiently determine which patients qualify for financial assistance programs. In short, Experian is using its data for good by helping make patients aware that they qualify for federal benefits or financial assistance, and effectively pairing them with the right program. From a provider standpoint, the data and insight that we provide not only enables them to determine which patients meet the requirements for Medicaid and other grant or charity programs, but also allows them to do so during the registration process, saving them time and effort on the back-end. Gaining insight into a patient’s financial situation also enables healthcare organizations to minimize or avoid potential bad debt, and improve reimbursement rates by connecting patients with financial programs or setting up a payment plan that fits within their current budget. The bottom line is, in order for healthcare organizations to continue to exist and assist patients in need, it’s important for them to remain financially secure. When healthcare organizations are better able to identify the difference between the patients who can pay versus those that are truly in need of and qualify for financial assistance, everybody wins. The patient doesn’t have to worry about a financial burden that they can’t afford and the healthcare organization can operate without the threat of closure. In order to protect their financial well-being, it’s important for healthcare organizations to identify those patients who qualify for financial assistance and those who can afford treatment. Dan Johnson, Experian’s Executive Vice President of Healthcare Strategy, discusses how big data can help answer that question.

A recent study conducted by Experian showed that a majority of vacationers overspend their budgets and rely on credit cards to provide extra funds. At the extreme end, more than half of millennial vacationers (52 percent) lean heavily on their credit cards, racking up vacation debt they’ll be repaying long after their trip comes to an end. The study also found that vacationers are only too happy to take a holiday from their normal good identity protection behaviors, as well. Whether a preventative action before the trip or a check-in after vacation ends, travelers are skipping easy opportunities to keep private information secure: for instance, only 38 percent of vacationers keep sensitive information protected in hotel safes while on holiday, and a disappointing 65 percent don’t have password protection enabled on their mobile phones. As summer begins, don’t give up on the strides you’ve made to spend responsibly and keep your private information secure. Staying in touch with your budget and protection practices year-round mean you won’t be off course when it’s time for a Labor Day weekend barbecue. View the complete survey findings and methodology here: Experian Summer Travel and Budgeting Survey Report, 2015 from Experian_US