Using What You’ve Got: 4 Valuable Insights Culled from Existing Healthcare Data

By Rose Higgins, President, North America, SCIO Health Analytics
Twitter: @SCIOanalytics

No matter where your organization stands on its journey toward value-based payment and care delivery, most will struggle to make a variety of critical, strategic decisions in order to determine the right methods needed to improve outcomes and prove value. The good news: You can apply predictive analytics to the reams of information that you already have to gain some much-needed direction.

By collecting and analyzing clinical, operational, and claims data with socioeconomic, psychographic, and other types of supplemental data, your healthcare organization can gain a 360-degree view of myriad performance trends and draw insightful conclusions. More specifically, you can use predictive analytics to:

1. Keep pulse on the quality of care being delivered.
By doing so, you can understand where the opportunities to improve patient/member outcomes exist. For example, you can segment and prioritize the patients/members who have the greatest risk of negative outcomes and then focus your efforts on those for whom closing care gaps will deliver the greatest health and financial outcomes.

2. Assess “impactability” by identifying which patients have care gaps.
You can then also use analytics to stratify the impact that closing those care gaps will have on outcomes – making it possible to determine which care gaps should be prioritized for the greatest impact.

3. Determine the most effective approach to take with chronic conditions.
Through an analysis of the data and performance, you can gain insights into how to take a proactive approach to managing chronic conditions based on current success rates of existing programs, and look across provider performance to drive quality measure compliance even higher.

4. Improve network performance.
By using data to gain insight into provider and patient/member behavior, you can uncover where and why leakage is occurring, understand referral patterns, drivers of cost and much more in order to reduce associated costs through patient/member and provider outreach.

These are just a few of the ways that your healthcare organization can leverage analytics to succeed under value-based care models. Can you think of any other strategies that could help?

This article was originally published on SCIO HealthAnalytics and is republished here with permission.