Are you getting the most out of your data? 

A lack of data visibility can be debilitating when trying to stay competitive and plan for future success. Analytics technology and services can increase visibility to help manage cost, risk and utilization, predict population health trends and measure quality.

Infusing data and analytics intelligence into your everyday workflow allows you to see the whole picture of health: a comprehensive view into the current state and future actuarial risk of member populations and the effectiveness of provider networks.

But how do you know what types of analytics are best suited to help your organization achieve success within its top priorities? First, you’ll need to identify where your top priorities fall within four strategic focus areas. Then, make sure you have access to the essential data and capability needs. 

Use the below to check if your priorities and capabilities are aligned. 

Financial Performance: efficiently manage cost and utilization

To efficiently manage utilization and financial performance, you need foundational analytic capabilities to identify clinical episodes of illness and the services involved in their diagnosis, management and treatment. Episodes of care provide a valuable unit of analysis to measure the utilization of health care services directed towards specific clinical conditions, as well as gauge the provision and financing of those health care services. You need foundational analytic capabilities and the ability to measure care with meaningful episodes of care to efficiently manage cost and utilization.

• High-quality and cost-effective care is a central mission. We believe you not only need to have visibility into your diagnosis, drug and procedure codes, but you also need to be able to use that information to identify care gaps. Learn how one organization used this insight to find $1.2B in potential savings.

• Consistent financial and clinical metrics for analyzing treatment of medical conditions is a key business need of any organization. See why over 70% of the market is using Optum grouping methodologies and how you can utilize groupers to measure care with meaningful episodes of care to meet market demands.

Outcomes: accurately and effectively measure quality

Keeping care consistent with evidence-based treatments is essential if you’re looking to improve health outcomes and lower costs. Effective quality measurement solutions facilitate increased compliance with evidence-based care standards and report gap-in-care opportunities for care managers to target interventions. For success in quality measurement, you need care consistency with evidence-based treatments combined with effective measurement solutions. 

• Evidence-based medicine (EBM) creates significant opportunities to enhance care quality and improve treatment outcomes. Learn how to appropriately evaluate quality of care at your organization to combat noncompliance with medical treatment standards that costs consumers and insurers up to $100 billion annually. 

• The increase in procedures combined with quality concerns and the rising cost of health care has led to a growing need to measure outcomes and appropriateness of care associated with a variety of procedures. Learn how to more accurately predict expected future costs for members with incomplete data and identify overuse of low-value health care services. 

Population Health Management: understand your whole population to better mitigate risk

Accurate and timely risk assessment requires a comprehensive view of your membership combined with the power of predictive analytics. A complete view allows you to stratify members and populations by a wide range of criteria, enabling you to find patients who are at high financial risk or likely to be admitted to the hospital. This rich insight is critical to improving your ability to manage populations proactively, and enhancing the clinical and financial returns on your population health management programs. 

• Social determinants can play a significant role in how members utilize health care resources and on likely outcomes. But is your organization utilizing this crucial data? See how gaining a deeper understanding of your membership can improve outcomes.

• Risk assessment can enable your organization the ability to better understand and predict health risks of members, while estimating future associated costs. Read more to learn how a valid, reliable risk assessment model can support accurate payment rates, obtain comparisons of provider performance and identify patients of highest risk. 

Care Management: manage care across the health care ecosystem

Successful care management calls for a platform driven by analytics with the ability to proactively and intelligently manage care. Stratifying your member populations and identifying which members should be addressed first allows you to focus on the highest priority issues for the greatest impact on care quality and cost, all in the name of reducing admissions, boosting care manager efficiency, and enhancing population health management efforts. Predictive analytics and an intelligent, integrated platform is what you need to drive your care management program's scalability and performance to improve outcomes.   

• Care managers need the insights afforded by powerful predictive analytics and deep care management capabilities to succeed. See how an intuitive, intelligent platform can help you achieve analytics-driven care management. 

• An effective care coordination platform puts important clinical information, assessments, and care plans in one place, allowing you to enjoy easy, seamless communication. Learn how one organization's care management strategy became analytics-driven and saw a 58% reduction in ER admission rates.

Not seeing your priorities listed above or not sure what to pick? We can help.