MIT boffins' code scans your health claims, tunes plans for bosses

A company spun out of MIT's research labs says it has developed analytics software that pores over employees' health insurance claims and tells bosses how to adjust their plans.

The software from Benefits Science Technologies (BST) is designed to scan staff claims for patterns of illness, or identify common risks, and then suggest how to best balance deductibles and monthly payments. News publishers might be told to focus on employee coverage for liver damage, for example.

Spun out of MIT's labs in 2012, BST counts a number of the university's grads and professors, including its chief scientist, among its management ranks. The company, based in nearby Boston, focuses on data analytics tools to help enterprises (between 500 and 50,000 employees) pick health insurance plans.

According to MIT, the BST software will seek out the patterns in treatment of employees and then use that information to suggest how a company health plan could balance premiums and deductibles in certain areas.

For example, MIT suggests the BST tools could spot when certain cancers or chronic conditions are on the rise in a company, then advise the company to adjust deductibles for those areas and save both employees and the company costs for those treatments. Lowering deductibles will drive up premiums, of course.

"Employees with forms of cancer, for example, may at one point require surgeries, or employees with diseases like Hepatitis C may require expensive drugs for a set period of time," MIT says of the software.

"Employers may want to ensure broader coverage and lower deductibles to address those conditions, which may raise premiums."

Additionally, the university claims, its spin-off will be able to spot risk factors for certain conditions among the employees of a company and advise the company on what preventive care could be used to catch a problem early and avoid a more costly surgery down the line.

The software would be offered both as a service to the companies who purchase the health care plans and as an online portal for individual employees, studying patient data to help workers pick which insurance package would be best suited to cover them. ®