Turning data into action: 8 tips for plans, providers

While data analytics presents great opportunities for health plans and providers to improve care quality while reducing care costs, 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, "What is your most pressing information technology problem?" the answer that received the highest percentage of responses was, "turning data into action." And, 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."

To help your organize make the most of its data, we asked three industry experts to share their tips.

Scott#1. Foster plan-provider collaboration. While health plans have a large amount of administrative data at their disposal, such as members' basic demographic information, diagnosis codes, and procedure codes, they lack easy access to clinical data, says Greg Scott, national leader of the health plans practice at Deloitte Consulting, LLP. If they had it, and it could be easily combined with administrative data and shared with providers, providers would be able to better identify and address patients' health needs in real time, he says. As a result, it's critical for plans and providers to work more closely together to share data and apply it in real time. "Only by working together can we consolidate and normalize and utilize the various sources and types of data that are required to really have actionable information," he says.

#2. Engage physicians. Physicians are a key aspect of capturing and generating data so their engagement with data capturing technology, such as EHRs, is critical. "... If they don't buy in to the benefits of the analytic outputs, then you have a really hard time getting quality data," says Larry Yuhasz, national practice leader, population health, at Truven Health Analytics.

Yuhasz#3. Offer value-based payment. Value-based reimbursement may help push physicians to become more engaged in data capture, generation, and application. That's because data analytics can help pinpoint key areas where costs can be reduced and quality can be improved. "The financial integration will support clinical integration," says Scott. "... If the money is suggesting that plans and various types of providers need to link arms in a more collaborative way to focus on the information required to make the new value-based payment system work for all the stakeholders, that's big."

#4. Move toward a single data repository. Most plans have many data repositories that are accessed in different ways by different departments, says Anita Nair-Hartman, vice president of strategy and business operations for payer business at Truven Health Analytics. "I think that they are starting to, and I think they need to continue this investment of having a single source of health information to help drive their business."  

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