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Increasing ROI in Healthcare Analytics

By Nick Conway, SVP, Head of Product, NFP

Nick Conway, SVP, Head of Product, NFP

The future of healthcare is data driven, but how do we get there and who can help us move faster? In healthcare, a historically archaic industry stuck on old and slow moving platforms, fortune 50 companies, entrepreneurs, startups, and consultants are disrupting “Big Business” with smarter and quicker 3rd Party plug and play solutions – This is what healthcare calls “InsureTech.”

InsureTech is one of the hottest investment sectors for both private and public capital. It is modernizing the aging infrastructure and communications platforms of slow, out of date fortune 50 companies by connecting data sources, bringing key metrics to life, and providing better cost effective care (ROI). When clients choose the right partners, they enter a new era of turning their data into an asset to make informed cost effective decisions.

Data Sources

Fundamentally, data is the bedrock of making better decisions. But what data are we talking about? Intoday’s information driven environment you need real time data standardized across multiple subsets known as digitalized health data. Being able to plug into existing IT infrastructure through modern APIs or connectors has allowed us to turn messy data sets into circuit boards to impact real decision trees.

"The biggest change in health analytics starts with the ability for multiple parties to receive data more frequently"

In the past, payors have been subject to making decisions often times three to 12 months after a claim is processed. We receive a report card on the past telling us what should have happened in a given time period. In this process, 80 percent of the data will become dark or useless information. For example, if you have a patient prescribed for a four-month regimen for the treatment of Hepatitis C, the use of a $32,000 Harvoni prescription instead of a $12,000 Mavret prescription may cost the plan $80,000 more to treat the patient. Unfortunately, the patient will have already completed their prescribed regimen by the time you receive your report.

The biggest change in health analytics starts with the ability for multiple parties to receive data more frequently. In our Hepatitis C patient, we could intervene before the member ever received their first fill of the medication. By standardizing data inputs, we have been able to build consistent algorithms to target individualized claims with real time data.

Visualizing Data

All businesses are expecting employees to migrate manual activity to automated technology to complete our daily routines more efficiently. How we leverage data in healthcare has been simplified by the open source and cloud-based analytics businesses. Dashboards, apps, Internet of things and many other versions of SmartTech are examples of how we mine data and provide visual context so that key healthcare stakeholders can easily understand and make decisions upon the information.

In healthcare, historically we have looked at each patient uniquely. Data and visualizations have allowed us to connect multiple patients through patterns and trends. By learning from the complex user data across large subsets of patients, data visualizations can connect scenarios alerting the correct providers of more cost effective solutions.

ROI from Your Data Assets

At NFP, we were early adopters of integrating big data and standardizing data sets. We worked with our vendor partners to automate data flows into our secure data platform and dedicated resources to map the incoming data from multiple providers into one data set. Therefore, regardless of your provider we are able to apply the same set of algorithms to dig into your data to utilize targets appropriately.

Our modern data stack allows account managers, clinicians, and executive leadership to visualize the same data and leverage appropriate benchmarks to utilization. Artificial intelligence is built into our dashboard with automated alerts to enable decision-making in real time. The data inflow and proprietary big data dashboard are our circuit board.

The underlying principle of data analytics is not about providing better information, but providing better outcomes. The NFP team truly differentiates us by turning our client’s data into an asset. Our clinical team takes the automated information and drives better outcomes through patient and provider communications. Our alert system and clinical team serve as our decision tree to drive better outcomes.

CIOs, CSOs, and Data Scientist in the Insurance Industry are faced with a complex technology ecosystem with very large legacy vendors. Migrating to more efficient visual data stacks can allow them to not only provide better analytical expertise, but more importantly, can lead to more cost effective patient care. Our team does this by leveraging unique vendor partnerships that drive better results.

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