US health plan analytics survey: Becoming an insight-driven organization

Many health plans are facing uncertainties: the changing health insurance landscape, the speed at which value- based care is approaching, and growing demands from customers, to name a few. At least one investment may help executives meet each of these challenges—an investment in analytics. Health plans are data rich, yet those data are not always leveraged to understand what happened and why, or predict what is likely to happen. Health plans that do not take advantage of their data may risk being disrupted and left behind.

The Deloitte Center for Health Solutions conducted an online survey of 45 analytics professionals at health plans (with 250,000 or more members) to better understand the priorities and challenges of implementing analytics within a health insurance organization. Nearly 40 percent of respondents represented Blue Cross Blue Shield affiliates, and of those that had an enterprise analytics leader (n=35), over 80 percent reported to a vice president or higher.

The survey helps to provide a window into top-of-mind issues facing health plan analytics departments. The Center also conducted 15 interviews with executives at health plans and technology companies to better understand leading practices and lessons learned from insight-driven organizations.

Key findings from our survey and interviews include:

1. Analytics is a critical asset for long-term strategy: Two-out-of-three survey respondents agreed that analytics is extremely important to their organization as a competitive differentiator. As many early adopters of analytics begin to see tangible results (e.g., increased efficiencies, improved affordability/ reduced medical costs, or enhanced customer engagement/experience), later adopters will likely need to catch up or be left behind. Projected spending on analytics mirrors this view—33 percent of respondents expect spending on analytics will increase substantially over the next three years. Despite many being in a resource limited environment, interviewees stated that their leadership understands the value that analytics brings to the table, and supports investments.
2. Analytics drivers are business drivers: Financial goals, such as reducing medical and operating costs, are among the leading drivers of analytics investments among survey respondents. Clinical and customer analytics are priority investments in the next year, particularly in the areas of cost and utilization management and customer experience.
3. Many health plans prefer to buy vs. build their own solutions: Rather than build them, more than half of survey respondents intend to buy, rent, or use a hybrid approach to acquire solutions to their top analytics priorities in the coming year and over the next three years. However, respondents preferred to keep day-to-day analytics activities in-house. Our interviews suggest that keeping analytics in house is more secure, and health plan analytics requires market and organizational-specific business knowledge that is not easy to outsource. Deloitte believes analytics is a critical part of health plans' business models, and retaining in-house expertise will likely be essential to their long-term competitiveness.
4. Data quality, technology, and access to skilled labor are big barriers to analytics investments and implementation efforts: Data quality is the most commonly cited barrier to analytics investments and implementation, followed by asset-related barriers: tools and technology, access to skilled resources, and funding. Without enterprise-wide agreement on data definitions and requirements, analytics outputs are not trusted and can lead to ineffective insights. Thus, health plans could benefit from investing time and resources to ensure the data they use are valid and meaningful. Additionally, as health plans try to improve their technology, they are met with a plethora of technology options in the market that can be overwhelming when determining the best course forward. Finally, with skilled analytics labor in short supply, health plans will likely not only have to compete with each other, but with other industries as well to capture talent.
5. Analytics functions are generally centralized within an organization: While most survey respondents stated that analytics functions related to hardware/infrastructure, data storage, and data preparation are primarily owned by information technology (IT), there was a closer split of IT and business ownership for the building of reports. Despite differences of primary ownership, the majority of respondents stated that their analytics functions were generally centralized into a shared service for the enterprise to capitalize on economies of scale and competency. Regardless of which function is owned by IT or business, a coordinated, business-driven approach to analytics is generally key to ensuring that analytics initiatives are aligned with business goals.

Read more in: 2017 US health plan analytics survey.