Study uses healthcare claims data to identify Covid-19 risk factors without prior selection.
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Deep Claim predicts payer responses from claims data using deep learning.
Due to escalating healthcare costs, accurately predicting which patients will incur high costs is an important task for payers and providers of healthcare. High-cost claimants (HiCCs) are patients who have annual costs above $\$250,000$ and who represent just 0.16% of the insured population but currently account for 9%…
Causal thinking improves healthcare decisions from EHRs.
Deep neural network predicts health costs better than traditional models.
LMM predicts healthcare costs and risks with improved accuracy.
Representation learning methods that transform encoded data (e.g., diagnosis and drug codes) into continuous vector spaces (i.e., vector embeddings) are critical for the application of deep learning in healthcare. Initial work in this area explored the use of variants of the word2vec algorithm to learn embeddings for m…
Fraud causes substantial costs and losses for companies and clients in the finance and insurance industries. Examples are fraudulent credit card transactions or fraudulent claims. It has been estimated that roughly percent of the insurance industry's incurred losses and loss adjustment expenses each year stem from…
It is not clear how to target patients who are most likely to benefit from digital care management programs ex-ante, a shortcoming of current risk score based approaches. This study focuses on defining impactability by identifying those patients most likely to benefit from technology enabled care management, delivered …
SARD improves deep learning clinical prediction performance.
Risk adjustment has become an increasingly important tool in healthcare. It has been extensively applied to payment adjustment for health plans to reflect the expected cost of providing coverage for members. Risk adjustment models are typically estimated using linear regression, which does not fully exploit the informa…
Study identifies risk factors for subsequent suicide attempts in youth.
Type 2 diabetes mellitus (T2DM) is a chronic disease that often results in multiple complications. Risk prediction and profiling of T2DM complications is critical for healthcare professionals to design personalized treatment plans for patients in diabetes care for improved outcomes. In this paper, we study the risk of …
Managing patients with chronic diseases is a major and growing healthcare challenge in several countries. A chronic condition, such as diabetes, is an illness that lasts a long time and does not go away, and often leads to the patient's health gradually getting worse. While recent works involve raw electronic health re…
Probabilistic ML improves healthcare data analysis.
A statistical description and model of individual healthcare expenditures in the US has been developed for measuring value in healthcare. We find evidence that healthcare expenditures are quantifiable as an infusion-diffusion process, which can be thought of intuitively as a steady change in the intensity of treatment …
Big data analytics improves healthcare through early detection and quality life.
One of the main issues affecting the Italian NHS is the healthcare deficit: according to current agreements between the Italian State and its Regions, public funding of regional NHS is now limited to the amount of regional deficit and is subject to previous assessment of strict adherence to constraint on regional healt…
This paper solves the problem of optimal dynamic consumption, investment, and healthcare spending with isoelastic utility, when natural mortality grows exponentially to reflect Gompertz' law and investment opportunities are constant. Healthcare slows the natural growth of mortality, indirectly increasing utility from c…
LaCIM avoids spurious correlation by modeling latent causal factors.
Study optimal healthcare spending under Epstein-Zin preferences for longevity.
In rare disease physician targeting, a major challenge is how to identify physicians who are treating diagnosed or underdiagnosed rare diseases patients. Rare diseases have extremely low incidence rate. For a specified rare disease, only a small number of patients are affected and a fractional of physicians are involve…
Study improves conformal prediction for EEG classification in healthcare, enhancing coverage.
A recommendation framework helps users choose healthcare interventions.
Being able to interpret, or explain, the predictions made by a machine learning model is of fundamental importance. This is especially true when there is interest in deploying data-driven models to make high-stakes decisions, e.g. in healthcare. While recent years have seen an increasing interest in interpretable machi…
Reinforcement learning improves insurance claims reserving by learning from all claim trajectories.
The study analyzes how bonus-malus systems and delayed claims settlement affect insurance companies' financial stability.
Diabetes is a major public health problem in the United States, affecting roughly 30 million people. Diabetes complications, along with the mental health comorbidities that often co-occur with them, are major drivers of high healthcare costs, poor outcomes, and reduced treatment adherence in diabetes. Here, we evaluate…
Distributed representations have been used to support downstream tasks in healthcare recently. Healthcare data (e.g., electronic health records) contain multiple modalities of data from heterogeneous sources that can provide complementary information, alongside an added dimension to learning personalized patient repres…
Method constructs prediction intervals for time-varying individual treatment effects.
Study improves healthcare time series imputation by considering structured missingness.
Recent years have witnessed widespread adoption of machine learning (ML)/deep learning (DL) techniques due to their superior performance for a variety of healthcare applications ranging from the prediction of cardiac arrest from one-dimensional heart signals to computer-aided diagnosis (CADx) using multi-dimensional me…
While artificial intelligence (AI) and other automation technologies might lead to enormous progress in healthcare, they may also have undesired consequences for people working in the field. In this interdisciplinary study, we capture empirical evidence of not only what healthcare work could be automated, but also what…
Unified framework for imputation and prediction in healthcare time series.
Study analyzes factors influencing healthcare providers' engagement with SMS campaigns.
MCRAGE generates synthetic data to balance healthcare datasets.
Modeling disease progression in healthcare administrative databases is complicated by the fact that patients are observed only at irregular intervals when they seek healthcare services. In a longitudinal cohort of 76,888 patients with chronic obstructive pulmonary disease (COPD), we used a continuous-time hidden Markov…
Research predicts healthcare index movements using historical OHLC data.
Unsupervised model detects healthcare fraud from patient visit data.
Proposes a method to improve rare event prediction in healthcare.
VHGM-MAE generates synthetic humans from healthcare data.
New method for individual claims reserving using machine learning.
The tail of the distribution of a sum of a random number of independent and identically distributed nonnegative random variables depends on the tails of the number of terms and of the terms themselves. This situation is of interest in the collective risk model, where the total claim size in a portfolio is the sum of a …
Optimal healthcare investment timing in a dynamic model with mortality risk.
From medical charts to national census, healthcare has traditionally operated under a paper-based paradigm. However, the past decade has marked a long and arduous transformation bringing healthcare into the digital age. Ranging from electronic health records, to digitized imaging and laboratory reports, to public healt…
Hybrid Bayesian-conformal framework improves uncertainty quantification in healthcare predictions.
Two machine learning models detect anomalies in ER claims, saving up to 40% in improper payments.
Optimizes insurance processing capacity to minimize costs.