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Author Bio

Luke Skelley

Luke Skelley joined Health Catalyst in May 2013. Luke’s clinical nursing background was in critical care and he managed organ and tissue donation programs for 13 years. His background includes orthopedic products, severity adjusted outcomes software for Medstat Group, clinical pathway development software for CareScience and prospective payment methodologies for Optum Insight. Luke was recruited by Navinet for a new line of clinical products for physician offices before they were acquired by Lumeris. Luke has a BSN and MSN in critical care nursing from the University of Tennessee and an MBA from Belmont University.

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Insights

Luke Skelley
Matt Denison
Rob McCrory

Six Challenges to Becoming a Data-Driven Payer Organization

As healthcare transitions from fee-for-service to value-based payment, payer organizations are increasingly looking to population health management strategies to help them lower costs. To manage individuals within their populations, payers must become data driven and establish the technical infrastructure to support expanding access to and reliance on data from across the continuum of care.
To fully leverage the breadth and depth of data that an effective health management strategy requires, payers must address six key challenges of becoming data driven:

Data availability.
Data access.
Data aggregation.
Data analysis.
Data adoption.
Data application.

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Luke Skelley

ACO Success Requires Precise Patient Population Definitions

An ACO will fail without precise patient population definitions. ACOs need to define populations for many reasons, including identifying their members and attributing those patients to the correct physician and performing population health analytics. The challenges to a good population definition are: multiple providers per member, multiple data sources, and multiple identifiers for each member. Using a clinical integration hierarchy to refine population and subpopulations will solve a lot of these issues. A data warehouse is the foundation that makes it possible.

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Bobbi Brown, MBA
Luke Skelley

The Key to Overcoming the Challenges of Transparency in Healthcare

Transparency in healthcare will drive cost and quality improvements for payers, providers, and patients alike. Consumers want to know true out-of-pocket costs and quality information for their providers. Physicians want to know about their potential referrals partners’ level of quality. In addition, transparency between payers and providers needs to improve to drive down costs. This trend presents challenges such as limited/siloed data access and cultural change. An EDW and analytics system can help transform a health system, improving value and patient/staff satisfaction.

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Bobbi Brown, MBA
Luke Skelley

The Best Way to Make Payer and Provider Healthcare Data Accessible

Payers and providers agree that focusing on quality is important. CMS, the HEDIS®, and the Joint Commission all have quality measures hospitals need to consider. Payers have their own set of quality initiatives. Healthcare data is an important part of determining the performance of those quality measures. But complications abound when trying to combine payer and provider healthcare data and measurements. The result is a time-consuming process resulting in reduced ability to analyze the data to drive improvements. Having payer and provider data available would be a huge advantage and is possible through a healthcare enterprise data warehouse. A Late-Binding™ approach provides the flexibility and adaptability needed for quality initiative teams to effect real change within their organization.

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Luke Skelley

Key Things to Look for in an ACO Analytics Solution

The best solution for leveraging data to drive clinical and financial improvement in an ACO environment is a healthcare enterprise data warehouse (EDW) with a flexible, Late-Binding™ architecture. Why? Because a successful analytics solution for an ACO must be one that:
i. 1. Gives rapid time-to-value.
ii. 2. Adapts easily to the changing needs of an organization.

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Luke Skelley

Accountable Care Means Sharing Data Between Payers and Providers: You’ll Need More than an EHR

Accountable care is changing the way Payers and Providers look at their healthcare data. Many healthcare enterprises believed that their Electronic Health Record (EHR) would be the silver bullet to this data problem, but they are beginning to discover the limitations of the EHR for managing at the enterprise-level all of the information necessary for effective risk-sharing. Health information exchanges (HIEs) help eliminate data silos but are not designed to store or analyze the data with the level of sophistication required for supporting a risk-sharing model. The reality is, until now, providers and payers have lacked consistent incentives to share data.

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Luke Skelley

How Would An Accountable Care Approach Change How A Patient is Treated?

How would an Accountable Care approach change how a patient is treated? It’s important to recognize that accountable care isn’t just a piece of legislation or a new organizational or payment structure. Nor is it just applying technological advances to make healthcare more efficient. It is a fundamental shift in making people accountable for how care is delivered and experienced. And it is founded in the shared responsibility we all have—patients, providers and payers—to make sure our healthcare dollars are used wisely and well. In this Insight, Luke shares an example of a healthcare episode of resource misallocation that could have been avoided by accountable care.

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