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Survey: Big data presents top challenge for managed care executives


Greg Scott, national leader of the health plans practice at Deloitte Consulting, LLP, shares how plans and providers may be able to better apply big data.

Data analytics presents great opportunities for health plans and providers, but many are struggling to realize its full potential. That's according to the results of Managed Healthcare Executive's 2015 State of the Industry Survey, through which more than 600 executives at health systems, health plans, pharmacy benefit organizations, and more, revealed their biggest challenges and priorities moving into 2016.

When asked, "How well would you say your organization is using big data to improve healthcare quality and reduce healthcare costs?" only 10% of respondents said, "very well, it's making a big impact."

READ - State of the Industry Survey Results: Top 5 industry challenges of 2016

ScottFor those who are struggling in this area, Greg Scott, national leader of the health plans practice at Deloitte Consulting, LLP, recommends focusing more on analysis and intervention in specific areas, such as a particular chronic disease management problem.

"It's often more practical to get the right stakeholders involved on a specific question, and then integrating-sometimes even on an ad hoc basis-various sources of information to shine the light on the art and the science of the possible about what you can do when you have the right data and have the right people working together," he says. "Sometimes focusing on specific clinical questions, on specific subpopulations, can lead to the early wins that build trusted relationships, and pave the way for incremental expansion of those sort of analytic and intervention collaborations."

For example, Deloitte recently helped a large, mostly Medicaid health plan, address concerns related to potential abuse of prescribed medications. "We brought in our PhD data scientist to focus on this really narrow question with a really big health plan, and of course not that we wouldn't want to work on a big program of data analysis, but sometimes bringing specific techniques on very focused questions really works," Scott says. This closer analysis showed some "surprising patterns" that led to clinical initiatives, and initiatives to combat fraud, waste, and abuse, he says.

"By having some early wins, working with some providers and with this one health plan on this topic, we were able to say 'Wow, where can we use those kind of statistical techniques elsewhere to answer some other questions.'"


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