Insurance Implications of IBM's $100M Health IT Program

IBM has announced a three-year, $100 million health IT initiative, InformationWeek reports. In addition to developing solutions for doctors and hospitals, IBM is working with the National Account Service Company (NASCO) on a health insurance component.Cloud computing is a major part of the insurance work, IBM told InformationWeek. Its goal is to develop a system that helps insurers navigate the ever-changing world of regulation and information security about healthcare.

From the article:

NASCO, a company that processes claims for BlueCross and BlueShield Plans, worked with IBM to create benefit plan traceability by examining existing benefit code and rules and mapping them back to industry concepts and constructs. The team created a technology that translates the different sequences of code into English, analyzes the sequences, consolidates similar functions into groups, and displays the translated code using several data visualization approaches.

Using IBM's expertise in analyzing complex, large-scale IT systems, the scientists have provided NASCO with a way to improve claims payment research while increasing the flexibility necessary to efficiently respond to new or changing healthcare regulatory and market requirements.

"What we have done is taken the rules for claims processing, which can get complex, and externalize them from deep code so that they become far more manageable and provide transparency and manipulability of those rules to enhance traceability of what was done as well as providing ease of extracting best practices," [IBM's global lead of healthcare transformation Chalapathy]Neti said.

Nathan Golia is senior editor of Insurance & Technology. He joined the publication in 2010 as associate editor and covers all aspects of the nexus between insurance and information technology, including mobility, distribution, core systems, customer interaction, and risk ... View Full Bio