Data and analytics can be the keystone to payer/provider collaboration

Change is the theme of the moment in health care. There’s a general recognition that moving toward a health system that prioritizes prevention and quality of care is the right way to go, but almost no agreement on how exactly to get there. Nobody said leaving the world of fee-for-service would be easy, but I don’t think we envisioned that adopting fee-for-value would be this hard.

I frequently hear from leaders at health plans, health systems and physician organizations that adopting value-based care is what keeps them up at night. It is becoming more apparent that payers and providers need each other’s help to succeed, which means more than being willing to collaborate. They also need common platforms and tools.

This symbiotic relationship can be based on data and analytics. Health plans that are able to anticipate the needs of their populations, design the right interventions, and effectively predict and manage the total cost of care in the short and long term will be the high performers. Leveraging the data available to them to both inform their strategies and track their metrics will be critical. Health systems will need to view payers as partners so that providers have the data they need to drive visibility into the value they are delivering.

There are four building blocks that both health systems and health plans need to consider as they evaluate where they are on the road to embracing value-based care – and accessing the right health care intelligence can help you with each one:

When payers and providers come together as strategic partners, it’s easier to maximize quality efforts and impact total cost of care. This is where sharing data and analytics that provide insight into quality, gaps in care and value delivered comes into play. You can read more about it here.

 

About the author:Steve Griffiths Headshot

Steve Griffiths, PhD, MS
Senior Vice President, Chief Operating Officer
Optum Enterprise Analytics

Steve Griffiths has more than 20 years’ experience in health analytics management, and currently heads up the Optum Enterprise Analytics organization. His main focus is driving growth and innovation through Optum products and services. Steve has a master’s degree in biostatistics from the University of Washington and a PhD in health services research, policy and administration from the University of Minnesota.

One thought on “Data and analytics can be the keystone to payer/provider collaboration

  1. I ran across a nice video from one of your peers at Optum from Optum Forum 2017 (https://www.optum.com/resources/library/nlp-ai-roi.html) along with a blog emphasizing “AI with ROI”.

    In it he mentioned that 80% of EHR data is unstructured, which is a number I have ran across frequently, but for the life of me I can’t find it in the literature. The best I can find is that this is “industry consensus”.

    Granted that companies such as IBM ( via IBM Health Cloud) will have deep insight into this number, but are there any other sources for this number?

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