BHI ®is the nation’s premier health intelligence resource.

It is a leader in the movement to provide greater healthcare transparency by delivering detail about healthcare trends and best practices, resulting in healthier lives and affordable access to safe and effective care.

BHI brings together the healthcare experience of more than 54 million Blue Cross and Blue Shield members nationwide. That makes BHI:

• the broadest, deepest pool of claims information ever created, and it’s growing
• the industry’s most reliable resource to help employers’ planning and decision-making
• the foundation of the Blues’ approach to evidence-based healthcare to help deliver higher quality care, improve health, and manage costs.

BHI helps employers give their employees greater confidence in the value of their benefits. BHI creates new collaboration opportunities for physicians, researchers and health policy makers – working together with the Blue Cross and Blue Shield companies – to improve the quality and consistency of care.

Good decisions begin with great information.

Employers that are customers of Blue Cross and Blue Shield companies participating in BHI are leveraging BHI’s comprehensive information – including comparisons with companies in their industries – to gain insights into a wide variety of healthcare trends, including:

• inpatient, outpatient and professional services utilization and cost variances
• demographic and risk trends
• opportunities to identify and address high-cost claims experiences

The reporting is comprised of aggregate, claims-based data that is HIPAA-compliant.

BHI information is supporting research to enhance Blue Distinction®, a designation awarded by the Blue Cross and Blue Shield companies to medical facilities demonstrating expertise in delivering quality healthcare.

What is BHI® (Blue Health Intelligence)? BHI, developed by participating Blue Cross and Blue Shield companies, is a unique resource that helps to improve healthcare quality through opportunities to share critical health information initially with employers, and in the future, with consumers and providers. As the premier health intelligence resource in the nation, BHI also strengthens the movement to greater healthcare transparency by ultimately providing unmatched detail about healthcare trends and best practices while protecting individual privacy. BHI sets the new standard for healthcare data aggregation, reporting and analysis.

Size and Value Why does it matter how much data BHI contains? In addition to a vast population sample, BHI contains extensive longitudinal data, which includes the healthcare experience of more than 54 million Blue Cross and Blue Shield members and 36 months of historical information. This means BHI supports reporting that can be trended with greater confidence. BHI also possesses market-leading breadth in terms of the levels of data grouping.

Why was BHI developed? The healthcare market is moving toward an evidence-based, decision-making model. Employers, consumers, and providers are demanding credible and actionable data. BHI addresses these needs. BHI plays a central role in the transformation of today’s present healthcare system into a focused, knowledge-based healthcare system. Through the participating companies, BHI supports the efforts of employers to better manage the healthcare benefits they offer their employees. In the future, BHI will provide consumers with the information they need to make informed healthcare decisions and will heighten collaboration with providers as they deliver high-quality, evidence-based care to their patients.

What value does BHI offer the healthcare industry as a whole? BHI gives the healthcare industry a steady flow of independently verified data and insights into healthcare trends. BHI data enhances the analytics offered by participating Blue Cross and Blue Shield companies, enabling them to:

• identify evidence-based approaches for the long-term improvement of provider network quality and efficiency
• work with employers to improve the health of their workforce health while better managing costs •
• help consumers become more engaged in their healthcare decisions •
• provide physicians and hospitals with powerful insights into emerging medical trends and treatment options
• create opportunities for medical experts and researchers to expand their knowledge •
• give policy makers accurate evidence on issues like drug safety and efficacy and the impact of new technologies and procedures

What makes BHI different from competitor’s offerings? BHI is the largest source of healthcare data and analysis, public or private. The precision of the measures, normative benchmarks, and geographic representation of BHI’s underlying data far exceeds the capabilities of other data warehouses.

Robust Benchmarks What types of benchmarks does BHI generate? BHI’s data produces a wide variety of benchmarks at the national, regional and metropolitan statistical area (MSA) level and for every standard industry classification code (SIC). 

What are some of the advantages of the benchmarks that BHI generates? Reporting that uses BHI data can show an employer’s incurred costs in the following ways, among others: 1) breaking total cost down by actual MSAs or regions, 2) comparing the employer’s costs to those of companies in the same industry (identified by SIC code), 3) benchmarking the employer’s costs to those of similar companies by type of product (PPO, HMO, etc.). BHI’s robust data set makes possible greater breadth and granularity of geographical analysis, more meaningful intra-industry comparisons and clearer insights into the effectiveness of product types. BHI also enables reporting not only by MSA, industry and product type, but by additional factors including Diagnosis Related Groups (DRG) code, age group and gender.

Data Integrity What quality assurance process guarantees the validity of BHI data? BHI employs the most rigorous healthcare data certification process. The Data Certification process ensures that:

• •  the data set provided by a given Blue company is statistically reliable and data integrity has been maintained
• •  the data from each participating company is standardized and consistent with the entire BHI data set, thus ensuring meaningful comparisons and answers to queries
• •  modifications and calculations performed on the data to derive benchmarks are performed correctly

How does Data Certification work? A company’s data set must pass the industry’s only independent actuarial review by Milliman.

Privacy and Security How does BHI ensure the privacy and security of members’ healthcare information? BHI’s security protocols strictly safeguard members’ personal health information (PHI). BHI adheres to Health Insurance Portability and Accountability Act (HIPAA) regulations throughout the collection and processing of company data, as well as the process of calculating and presenting benchmark information. The use of a system-generated identifier masks a person’s actual identity, while allowing longitudinal analysis of health experience over time.  All reports produced by BHI are fully de-identified in accordance with HIPAA requirements.