Published Articles

Health Analytics Firm Expands in West Hartford 

Greater Hartford is one of the smallest employment centers for SCIO Health Analytics, but one of the most critical sources of talent, according to CEO Siva Namasivayam.

Namasivayam, who lives in Westport, said the company, which is barely more than five years old, is about to reach the 500-employee mark, with 100 hires in the last year. Of those, 35 work in West Hartford, up from 18 a year ago, when the company's headquarters were located in Farmington.

The company relocated to 6,674 square feet in West Hartford in January, with more space available in the building for expansion. Namasivayam said it's possible the Connecticut office could add 25 to 50 people over the next year, depending on the kinds of deals the company strikes.

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Farm'ton's SCIO Health relos to W. Hartford

SCIO Health Analytics has moved its eight-year-old headquarters to West Hartford from Farmington, to accommodate its future expansion, authorities say. Its main office is now at 433 S. Main St., in Corporate Center West; previously it was at 233 Farmington Ave. The company analyzes patients' health data to enable health plans, employers and others to improve their quality of care and outcomes.

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Enabling Analytics for Successful Accountable Care

For all its complexities, the U.S. healthcare system is making progress toward becoming a more effective and efficient industry. But there are some glaring challenges that must be resolved to ensure that patients are receiving the highest quality, most affordable care possible.

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Impact of Clinical Oral Chemotherapy Program on Wastage and Hospitalizations May 2012

The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring (ie, split-fill) plan for early identification and management of adverse effects. If serious adverse effects are identified mid cycle, the remainder of the monthly supply is withheld, thus avoiding potential waste associated with early therapy discontinuation. This study investigated medication wastage and estimated potential cost savings for patients who were enrolled in the CMP, as compared with those who were not enrolled in the program.

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Community pharmacy and mail order cost and utilization for 90-day maintenance medication prescriptions JMPC April 2012

Pharmacy benefit management (PBM) companies promote mail order programs that typically dispense 90-day quantities of maintenance medications, marketing this feature as a key cost containment strategy to address plan sponsors’ rising prescription drug expenditures. In recent years, community pharmacies have introduced 90-day programs that provide similar cost advantages, while allowing these prescriptions to be dispensed at the same pharmacies that patients frequent for 30-day quantities.

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Health Insurers Are Beginning to Embrace And Innovate in Value-Based Design Plans.
This article discusses the advantages of value-based benefit design and how this model can help overcome several common challenges associated with prescription drug adherence. By, David Hom President, Consumer & Provider Engagement along with Jan Berger, MD, CMO at Silverlink Communications; Cyndy Nayer, president for the Center for Health Value Innovation; Ed Pezalla, MD, national medical director for pharmaceutical policy and strategy for Aetna.

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"Medication Adherence for 90-Day Quantities of Medication Dispensed Through Retail and Mail Order Pharmacies" by Nikhil Khandelwal, PhD, BPharm; Ian Duncan, FSA, FIA, FCIA, MAAA; Elan Rubinstein, PharmD, MPH; Tamim Ahmed, PhD, MBA; Cheryl Pegus, MD, MPH; Patricia Murphy, MPH; and Kenneth E. Kudrak, ASA, MS, MA - Manuscript Published in The American Journal of Managed Care, November 2011.

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"Value-Based Benefits: Are We There Yet?" by Jeff Elliott. Published in HealthLeaders Media, February 16, 2011.

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"Cost-effective healthcare analytics" by Siva Namasivayam. Published in The Hindu Business Line, February 2011.

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"Diabetes education: Investment reaps dividends" Published in Drug Topics, November 2010. Julia Talsma, Editor-in-Chief.

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"Predictive Modeling and Analytics Help Prevent Claim Overpayments" by Rodger Smith. Predictive Modeling News, November 2010.

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VBBD - A Roadmap for Improving the Health of Your Employees and Your Organization.

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"In Their Own Words: Palma Outlines Specialty Rx Payment Strategies". Drug Benefit News, 11 (3) February 5, 2010.

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"Is your care management program delivering results?" Ian Duncan, FSA, FIA, FCIA, MAAA. Benefits and Compensation Digest, December 2009.

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"Health Claims Savings - The Search for Credible Analysis" Ian Duncan, FSA, FIA, FCIA, MAAA. Contingencies, November/December 2009.

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"Health Plans Tackle DM: Software innovations enable health plans to structure results-driven disease-management programs and demonstrate true ROI" Christian Birkmeyer and Ian Duncan, FSA FIA FCIA MAAA. June 2009

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"Quantifying Care Management: Emerging Technology Quantifies ROI for Care Management Programs" Christian Birkmeyer and Ian Duncan, FSA, FIA, FCIA, MAAA. June 1, 2009

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"Trim Expenses and Improve Subrogation Settlement Ratios" Timothy E. Cahill And Blaise J. Guzewicz, J. D. The Subrogator, Spring/Summer 2009.

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"Advanced subrogation software identifies OPL claims before they are paid" Timothy E. Cahil. Managed Care Outlook 22 (2), January 2009.

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"Harnessing the Forces of Marketing and Innovation" Ian Duncan FSA, MAAA (This essay won second prize in a thought-leadership essay contest sponsored by the Society of Actuaries)

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"Predictive Modeling, Stratification Improve Disease Management Risk Profiling" Ian Duncan, FSA,FIA,FCIA,MAAA. November 1, 2008

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"Care And Disease Management: An Actuarial Response" Ian Duncan. Benefits & Compensation Digest, 42 (8) August 2005.

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"A comparative analysis of chronic and non-chronic insured commercial member cost trends" by Ian Duncan, Robert Bachler and Iver Juster. North American Actuarial Journal, 10 (4) October 2006.

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"Its time for the Industry to move on from ROI" by Ian Duncan, from Disease Management 7 (3) 2004.

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"Evaluating the Results of Care Management Interventions: Comparative Analysis of Different Outcomes Measures" by Henry Dove, Ph.D. and Ian Duncan, FSA, MAAA. Available in bound paperback for $35, including S&H

  • Paper 1: Programs and Interventions describe popular care interventions that managed care organizations have used to change patients' and providers' utilization patterns.
  • Paper 2: Actuarial Issues in Care Management Interventions discusses methodological and measurement issues faced by actuaries who work or consult in the healthcare industry.
  • Paper 3: Selective Literature Review of Care Management Interventions reviews the existing literature on program evaluation, particularly the literature regarding reductions in cost and improvement in clinical quality, and discusses in more detail results as published in the peer-reviewed literature.
  • Paper 4: Understanding the Economics of Disease Management Programs presents an economic model for care management interventions. This paper also discusses the underlying components of a disease management program and how these components are structured and interact to drive the outcomes.
  • Paper 5: Outcomes and Outcome Measurement Methodologies survey frequently encountered outcomes measurement methodologies.
  • Paper 6: An Actuarial Methodology for Evaluating Disease Management Outcomes defines an actuarial methodology for structuring a study and assessing outcomes. The model is applied and some of its key assumptions are tested in Part 3 of the study. Part 3 (in progress; expected publication mid-2005): Practical Applications
  • Paper 7: A comparative analysis of chronic and non-chronic population trend (joint study with American Re HealthCare).
  • Paper 8: Practical Application of different outcomes measurement methodologies (joint study with Highmark).
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"A comparative analysis of claims-based methods of health risk assessment." Robert Cumming, FSA MAAA, for the Society of Actuaries (2002). The most comprehensive evaluation published comparing different risk-adjustment and predictive models. Available Free of Charge on Request.

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"Does a High Deductible Plan Lead to Good Purchasing Decisions?" Ian Duncan. Contingencies, July/August 2004.

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"New, integrated model of care targets risk rather than disease" Published in Disease Management Advisor, April 2007. Dorothy Brooks, editor.

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"Population Risk Management", Health Section News, Society of Actuaries. June, 2002.

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