Data analytics are a necessary ingredient for insurers creating accountable care organizations because they're key to helping providers improve the quality of care they deliver to ACO participants.
Salt Lake City-based Intermountain Healthcare collects data from its clinical and financial systems to create "data marts" that focus on certain areas of analysis, reported Health Data Management.
"We place that data into our enterprise data warehouse and then we do analytic processes on that, learning and gaining insights. And, from that, we create actions for interventions to improve the quality of care," says Stanley Huff, chief medical informatics officer for Intermountain Healthcare. "Anytime we look at the data we find out things we didn't know. It always pays to look at the data."
Intermountain's ability to analyze data also lies in its 40 full-time employees, including 29 data architects and 11 business intelligence developers. Huff's team members are all experts in statistical processes and work solely on analytics.
By using data in this way, Intermountain Healthcare has reduced elective inductions for pregnant women, which has led to fewer babies being admitted to the ICU--ultimately improving quality of care. And it has saved up to $2 million for each of its facilities, HDM reported.
University of Pittsburgh Medical Center, which owns hospitals and insurance plans in Pennsylvania, also is taking a novel approach with data analytics. The insurer has been using data analytics to examine data, including patient claims, prescriptions and census records, to predict which of its members are most likely to use the emergency room and urgent care facilities. Its forecasting models also include information about members' household incomes, education levels, marital status, race or ethnicity and number of children, the New York Times reported.
Analyzing these household details allowed UPMC to make some new realizations, particularly that mail-order shoppers and Internet users are more likely to use emergency services.
"It brings me another layer of vision, of view, that helps me figure out better prediction models and allocate our clinical resources," UPMC's Chief Analytics Officer Pamela Peele told the Times. "If you are going to decrease the costs and improve the quality of care, you have to do something different."
Data also plays a major role in Aetna's ACOs. The insurer shares all its claims data with its provider partners, believing that information empowers providers to deliver higher quality care at a lower cost, FierceHealthPayer previously reported.