There is a growing trend in the healthcare industry that is kind of scary and often times leads to increased insurance rates. Insurance companies have been partnering with data brokers to gather personal data on their customers. This lifestyle data is then combined with other consumer details about a person to make predictions on how much their medical costs could be. Insurance companies claim to now have a reliable baseline for determining a customer’s actual future health costs.
There has surprisingly been very little public scrutiny over insurance companies tracking people’s every move. Things like what people buy, what they eat, what TV shows they watch and what they are posting on social media channels is just the beginning of the type of data being collected. Computer algorithms are also using education level, net worth and marital status to predict how much a person’s healthcare could cost.
Personal Data Not Regulated by HIPAA
Personal data greatly differs from a person’s private medical information as there is little to no regulation for protection of a person’s lifestyle data. Even more concerning is that the high majority of people will feel that this type of data can not accurately predict health outcomes. As a result consumers will be unethically charged more because of personal data that they didn’t even know was collected or agreed upon to be used for increasing health insurance rates.
Another issue with insurance companies using this data without a consumer’s consent is the potential of the data being completely inaccurate. Personal data collected from data brokers is extremely error-prone and should not be used to make medical predictions or insurance price plans. Raising rates based on false information and discriminating against people tagged as “high-cost” is going to be a big issue.
Most health insurance companies deny using lifestyle data to compute insurance rates but they are obviously spending a lot of money to collect it. The health IT company Optum, owned by UnitedHealth Group, has collected medical information along with socioeconomic data for patients to link the medical outcomes with their personal data. The company advertises their ability to combine claims and clinical information to social media interactions like shared Facebook and Twitter information. This type of data is obviously appealing to insurers but also interesting to healthcare providers.
Value-Based Care Using Personal Data
In the past providers were compensated on the amount of service they provided. Now with the recent shift to value-based care, doctors are provided a lump sum to cover a time period or medical condition. Generally speaking the healthier a patient is the more profit a healthcare provider would receive. This has led to increased interest in any social factors that affect a patient’s overall health.
In a perfect world personal data would be used to calculate fair healthcare costs and insurance rates. Unfortunately the bad history of insurance companies doing whatever is possible to boost profits will have them using lifestyle data in unethical ways. The Affordable Care Act prohibits the denial of health coverage because of pre-existing health conditions or charging more to people with illnesses. Personal data can still be used to assess health risks and determine the price of insurance rates.
Personal Data Increasing Health Insurance Rates
Companies in the healthcare industry will continue to collect every piece of data they can get their hands on about people. They will then feed all of this information into a healthcare database (not covered by HIPAA protections) to analyze a person’s social activities. This lifestyle and personal data will then be used as factors for increasing health insurance rates.