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Matt Denison

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Matt Denison

Healthcare Analytics for Payers: How to Thrive Through Shifting Financial Risk

To stay in sync with healthcare’s transition to value-based care, payers today must develop the analytics capability to support alternative payment models and drive more value to their members. Payers can follow an analytics roadmap to develop a strategy that extends their data, analytics, and risk management expertise to meet growing demands.
The analytics roadmap helps the payer meet these common challenges of establishing a data-driven culture:

Recruiting and retaining high-quality providers in a competitive market.
Managing increasing numbers of high-risk/high-cost members with limited resources.
Efficiently reacting to federal and state legislative and payment changes.
Controlling the rising costs of healthcare services and pharmaceuticals.

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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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