Payer Solutions

It’s an exciting time in healthcare, with dramatic advances in precision medicine, genomics, artificial intelligence, machine learning, and new models focused on value-based care to help achieve the IHI Triple Aim of low cost, high quality, and optimal experience. Despite these important advances, the industry is up against a myriad of challenges—especially when it comes to data and analytics.

The Payer Challenge: Data Interoperability—A Roadblock for Effective Provider Collaboration

Optimizing the delivery of healthcare services that considers best practices, evidence, individual preferences, and cost is only possible if the data needed to inform the decisions is accessible. This data comes from an expanding ecosystem of disparate sources and must be aggregated and assimilated in ways that provide meaningful, actionable insight. For payers in particular, the top challenges are effectively collaborating with providers to access and share data, and removing the data interoperability obstacles due to these disparate data sources.

Fortunately, solutions to payers’ data interoperability challenges do exist, from legislation like the 21st Century Cures Act to Health Catalyst’s Analytics Platform. The Cures Act, approved by the U.S. Senate in 2016, promotes the free exchange of health information to improve care coordination industrywide. It facilitates data interoperability and payer-provider collaboration by improving access to data (clinical, financial, and operational), promoting health information interoperability, and prohibiting information blocking practices.

Health Catalyst’s Analytics Platform helps payers and providers collaborate with data and analytics to improve outcomes and transform healthcare.

The Solution: The Health Catalyst® Analytics Platform

Health Catalyst believes the traditional distinctions between payers and providers are evolving to embrace new models of delivering and paying for healthcare services. We believe that, with the right evidence, analytics, and methods, payers and providers can transform healthcare. Our passion is applying our experience and technology to expand the data available to payers so they can improve the outcomes, enhance the experience, and reduce the cost of healthcare for their members. We don’t believe that payers and providers harbor a resistance to sharing data. Instead, we recognize that there are technical challenges in aggregating data due to interoperability between a myriad of sources.

Health Catalyst’s Analytics Platform resolves these challenges and provides an adaptive warehouse of data complimented by a library of analytical applications to help payers improve efficiency. These applications define populations, stratify risk, analyze PMPM costs/payments, support care management, and deliver a host of other uses for these aggregated data sets.

Collaborative Analytics: Collaborations that focus on the Triple Aim are dependent on a data framework that supports sharing analytics and insights, and populates other information related to managing patient/member care.

Any Data Source: Virtually any structured or unstructured data source can be integrated into the Analytics Platform to create a flexible and adaptable data warehouse that supports collaboration based on analytics.

Fingerprinted Client Content: Client-specific content, such as data sources, risk models, metrics, benchmarks, and business lines that can be customized according to the client’s requirements.

Health Catalyst Content: Valuable content provided by Health Catalyst, including a library of applications, industry standard and proprietary risk and attribution models, and professional services that support collaborative analytics.

Open Access: The Analytics Platform architecture provides access to the data to support development of analytics for client-specific use cases.

Data Ownership: A suite of data management tools and professional services that support client ownership over data from data integration to governance.

The Health Catalyst Analytics Platform’s Late-Binding™ architecture addresses interoperability challenges through direct integration with the data source systems and the ability to load data with minimal transformation. This data extraction process simplifies the aggregation of data into an enterprise data warehouse (EDW), where it is used in a just-in-time fashion to meet a specific use case. The result is a flexible, adaptable data extraction and warehousing process that provides return on value in as little as three months.

Data in the Analytics Platform needed to support a specific use case is selected (i.e., bound) and then exposed in a relevant Improvement Application or ad-hoc query. Binding data, as required, provides the flexibility to support the expanding volume of data and related uses cases as they evolve over time.

Health Catalyst’s solution to the data interoperability roadblock is a flexible and open-access data Analytics Platform complemented with clients’ unique content and business requirements. Augmented with a wealth of Health Catalyst content and a focus on client ownership of the data, the Analytics Platform is the ideal framework for payer and provider collaboration.

Health Catalyst Payer Solutions & Product Road Map

There are several Health Catalyst solutions tailored to address payers’ unique challenges:

Health Catalyst has a very robust and exciting product roadmap that extends the value of data in the Analytics Platform to include:

  • Machine learning algorithms (, an open source repository of machine learning algorithms, is a free service to the entire healthcare community.
  • Patient-reported outcomes (PROs)
  • Social determinants of health
  • CAFE™ (Catalyst Analytics for Excellence) benchmarking

New Improvement Applications:

  • Financial decision support
  • Leading Wisely™ (executive decision support)
  • Accountable care
  • Operations and performance management
  • Clinical analytics and decision support
  • Care management and patient engagement

Learn More About Payer Analytics

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

3 Best Practices for Payer-Provider Collaboration to Improve Patient Care

The Late-Binding Data Warehouse Explained

Payer Success Stories

Managing Half-a-Million Risk-contracted Lives: Partners HealthCare Population Health Strategy

40,000 Covered Lives: Improving Performance on ACO MSSP Metrics

How to Reduce Healthcare Labor Costs by Using an EDW and Analytics

The Enterprise Data Warehouse (EDW): Creating the Foundation for Effective Healthcare Improvement Analytics

Faster Data Acquisition Delivers Speedy Time to Value

How to Integrate an EHR into a Healthcare Enterprise Data Warehouse in Just 77 Days

MultiCare’s Transformational Journey Toward Sustained Outcomes Improvement

To Build or To Buy a Healthcare Enterprise Data Warehouse? A Health System Experience

$74M in Healthcare Operational Improvements: How Texas Children’s Hospital Is Delivering on Its Vision

Improving Population Health Through the Use of Data and Reporting

Community Care Physicians Deliver Effective Population Health Management with Clinical Analytics

View Payer-Related Webinars On-Demand

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Will New Healthcare Policy Impact Value-Based Healthcare?

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New Health Plan Shows Commitment to Healthcare Quality

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