Medicine and Health Sciences Commons^™

Predictive Modeling In Post-Reform Marketplace, Wu-Chyuan Gau, Andrew France, Maria E. Moutinho, Carl D. Smith, Morgan C. Wang

Transactions of the International Conference on Health Information Technology Advancement

Healthcare reform changes everything. Annual and lifetime dollar limits, underwriting, and preexisting condition exclusion will all be eliminated by 2014. Insurers must offer coverage to any individual regardless of their health status. An overwhelming majority of those who will be mandated to purchase individual insurance is currently uninsured or under-insured. Insurers have insufficient internal data to estimate costs for this new population. A study on how to apply predictive modeling to deal with risks and uncertainties facing healthcare industry in the post-reform marketplace is presented in this article.