Bayes Hack 2016 |
Department of Health and Human Services Brief.

How can data connect individuals with the health providers they need?

Since the launch of health insurance marketplaces as part of the Patient Protection and Affodable Care Act (PPACA), millions of Americans have obtained new health care coverage. There have, however, been widespread consumer complaints; in particular, people tend to choose the wrong plan because relevant information isn't available or is inaccurate. Often, patients don't discover until after a purchase that their physician isn't in-network, or that an in-network specialist they need isn't taking patients.

In November 2015, the Centers for Medicare & Medicaid Services (CMS) enacted a new regulatory requirement for health insurers who list plans on insurace marketplaces. They must now publish a machine-readable version of their provider network directory, publish it to a specified JSON standard, and update it at least monthly. Finally, this data is becoming accessible.

But computer- and engineer-accessibility doesn't make it particularly accessible to the general market of health care consumers. The new challenge, then, is to transform this vast directory of provider data into insights that can guide individuals to the health care they're paying for, that they deserve, and that they often badly need.

How can data get help to sufferers of opioid addiction?

In 2013, 71% of prescription drug overdose deaths involved opioid painkillers. That same year, nearly two million Americans aged 12 or older either abused or were dependent on opioid painkillers.1 In recent years, even as the epidemic of prescription opioid abuse has eased somewhat, there has been a dramatic increase in overdose deaths related to heroin: death counts increased sixfold between 2001 and 2014.2

How can we leverage technology to detect abuse in early stages—perhaps by examining individual prescription use patterns—and to administer interventions, such as naloxone, in innovative and effective treatment plans?


Insurance marketplaces:

Opioid abuse:

  • The Bayes Impact starter kit, an exploration of this prompt's key datasets.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) compiles an Opioid Overdose Prevention Toolkit as a primer for caregivers and first-responders on the signs and treatments of various complications of opioid abuse.
  • The CDC aggregates data on prescription opioid overdoses.
  • The Centers for Medicare & Medicaid Services anonymize and collect geographic opioid prescription claim data down to a ZIP code level.
  • SAMHSA reports a wide variety of aggregate datasets related to substance abuse. Consider checking for data that's related to a particular project direction with this prompt.
  1. CDC Injury Prevention & Control: Opioid Overdose

  2. NIH National Institute on Drug Abuse: Overdose Death Rates (December 2015)