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Health-policyholder clustering using health consumption

Author

Listed:
  • Romain Gauchon

    (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon)

  • Stéphane Loisel

    (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon)

  • Jean-Louis Rullière

    (SAF - Laboratoire de Sciences Actuarielle et Financière - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon)

Abstract

On paper, prevention appears to be a good complement to health insurance. However, its implementation is often costly. To maximize the impact and efficiency of prevention plans these should target particular groups of policyholders. In this article, we propose a way of clustering policyholders that could be a starting point for the targeting of prevention plans. This two-step method mainly classifies using policyholder health consumption. This dimension is first reduced using a Nonnegative matrix factorization algorithm, producing intermediate health-product clusters. We then cluster using Kohonen's map algorithm. This leads to a natural visualization of the results, allowing the simple comparison of results from different databases. We apply our method to two real health-insurer datasets. We carry out a number of tests (including tests on a text-mining database) of method stability and clustering ability. The method is shown to be stable, easily-understandable, and able to cluster most policyholders efficiently.

Suggested Citation

  • Romain Gauchon & Stéphane Loisel & Jean-Louis Rullière, 2020. "Health-policyholder clustering using health consumption," Post-Print hal-02156058, HAL.
  • Handle: RePEc:hal:journl:hal-02156058
    Note: View the original document on HAL open archive server: https://hal.science/hal-02156058v3
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    References listed on IDEAS

    as
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    2. Nancy Beaulieu & David M. Cutler & Katherine Ho, 2006. "The Business Case for Diabetes Disease Management for Managed Care Organizations," NBER Chapters, in: Frontiers in Health Policy Research, Volume 9, National Bureau of Economic Research, Inc.
    3. Hainaut, Donatien, 2019. "A self-organizing predictive map for non-life insurance," LIDAM Reprints ISBA 2019026, Université catholique de Louvain, Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA).
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    5. Wehrens, Ron & Buydens, Lutgarde M. C., 2007. "Self- and Super-organizing Maps in R: The kohonen Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 21(i05).
    6. Bradley Herring, 2010. "Suboptimal provision of preventive healthcare due to expected enrollee turnover among private insurers," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 438-448, April.
    7. Scott Deerwester & Susan T. Dumais & George W. Furnas & Thomas K. Landauer & Richard Harshman, 1990. "Indexing by latent semantic analysis," Journal of the American Society for Information Science, Association for Information Science & Technology, vol. 41(6), pages 391-407, September.
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    More about this item

    Keywords

    Clustering Algorithm; Health insurance claims databases; Non negative Matrix Factorization NMF; Prevention; Kohonen self-organizing map;
    All these keywords.

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