My previous post outlined how increasing preventive services outreach can keep people healthier and result in better financial outcomes. But this can only happen if payers and providers know who need those services.
This is where population analytic tools come into play. The two components of successful population analytics are comprehensive data and technology systems to analyze that data. Together, data and analytics identify patients with debilitating and costly chronic conditions and help prioritize them for care. Data and analytics can also help highlight adults who have not received well visits and other preventive services, whether they have a known chronic condition or not.
Most health care organizations have data. But the data often is sequestered in multiple, siloed information systems. Health care leaders feel like they’re drowning in data but dying of thirst when it comes to understanding how their information fits together.
The answer to the data challenge? Population analytics systems that aggregate data from multiple sources into a single patient record. This coming-together can include data from clinical, claims, scheduling, census, socio-demographic, pharmacy, and other sources. Once combined, the information can be used to identify populations in need of preventive services and predict future situations that could be disastrous or costly.
By knowing what patients need well visits and preventive services, health care leaders can address financial, operational, and clinical imperatives for their organizations. Financially, that means finding patients at risk while also improving revenue for delivering preventive services. Evidence shows that preventive services save lives, and payers such as CMS and commercial plans are making huge investments to reimburse providers who advocate prevention.
Preventive services and screening in a fee-for-value model allow health care organizations to identify those at risk to incur higher-cost health care services. With data from population analytics systems, health care organizations have opportunities to identify healthy patients (and collaborate to keep them that way) and also identify those with simmering chronic conditions and intervene proctively.
In my next post, I’ll discuss how consumer awareness of preventive services and other innovations are helping ease the transition from fee-for-service to a value-based system.
For more on the subject, please download our full white paper: Why prevention matters.
–Carl Johnson, MD, EdM, MSc.
About the Author:
Carl Johnson, MD, EdM, MSc. is a pediatrician trained at Boston Children’s Hospital. He completed a Medical Education fellowship at Harvard Medical School and was a faculty health services researcher at The Mount Sinai School of Medicine.
Before joining Optum Analytics he worked as a physician executive at Cerner Corporation. He is a graduate of the Mount Sinai School of Medicine in New York City and has held faculty positions at Harvard Medical School, University of California at San Francisco, The Ohio State University, and The Mount Sinai School of Medicine.
Dr. Johnson believes that healthcare can be transformed with the help of the right data. When he is not helping to transform healthcare, he can be found playing tennis, cooking, perfecting his French, taking photographs, reading historical fiction, listening to music, and watching Ohio State Football.