Generating a decision support system for states in the USA via machine learning

Abstract

In literature, many studies try to analyze healthcare usage and generated decision support systems. In this paper, the aim is to generate a decision support system for insurance companies in the United States according to the federal dataset. The data set contains variables from the United States Healthcare Administration formal data group and they are; group of age, group of healthcare insurance, group of nationality, Corporate Social Responsibility (CSR) usage, and Advance Premium Tax Credit (APTC) usage. The best model for each state in the United States is determined with the dataset from 2014 November to 2015 February. In this study, various statistical models are attempted to generate independent and optimal models for each state. In the model selection process, three different metrics are used. Accuracy rate, f1score and precision score are used in the model selection process and models are compared to each other according to these three metrics for each state uniquely. Consequently, the proposed model is used with a decision support scheme to support customer service workers in healthcare insurance companies. The decision support system under consideration can facilitate a substantial decrease in the duration of interactions between customer service representatives and clients. Additionally, this system can generate more logically sound and efficient customer offers.