As the Affordable Care Act's rules and regulations continue to evolve, payers need health IT tools and analytics to better asses overall clinical and financial performance across multiple dimensions, according to a recent report from IDC Health Insights that was emailed to FierceHealthPayer.
However, various factors affect the implementation of payer analytics, including the development of value-based payments.
IDC Health Insights examined large payers from the Blue Cross Blue Shield Association, as well as other multistate and regional plans, to determine the best practices that can help payers implement analytics. Here are two examples from the report.
Price transparency. As the industry continues to adopt price transparency tools, payers can look to analytics to help them "create an illustrative picture for explaining the costs of care and benefits of treatment plans for consumers." Often, consumers don't understand the value of their healthcare nor do they know the real costs of treatment. By using analytics, payers can create an easy-to-understand discussion of value to help explain benefits to consumers that will, in turn, enable better decision-making.
Provider collaboration. In order for the industry to move paying for value rather volume, payers need to assist providers, most notably in terms of developing reports that can help providers manage patient information. For instance, payers can use technology to turn a combination of clinical data and claims data into acctionable insights for providers.
This is only the beginning, concluded Deanne Primozic Kasim, IDC's research director focused on payer health IT strategies. "While today's payer analytics applications provide a comprehensive set of executive-level and individual line-of-business reporting capabilities," she wrote, "there is room for future improvement in terms of the potential for better big data management and the integration of clinical, financial, wearable, remote, and other important sources of healthcare data."
- here's the abstract