Similar to health system executives, a majority of health plan leaders (67 percent) said data analytics is extremely important to their organization as a competitive differentiator, according to a 2017 Deloitte survey. A health plan with a large Medicare Advantage (MA) book of business attributes its consistently high performance on Star ratings to its analytics. Dedicated analysts keep constant watch on data that drive specific Star measures. If they see a downward trend, or if the tolerance threshold for that measure is crossed, the analysts raise the issue with the internal operations team (such as medical management) that can intervene and correct the trend. Information gleaned from claims data can lead to increased efficiencies, improved affordability/reduced medical costs, or enhanced customer engagement/experience, they said. About 75 percent of our health plan respondents expected their analytics spending would increase in the year ahead.
Hospitals and health systems that are lagging their competitors should consider developing a strategy to incorporate analytics. Health systems that already have mature analytics capabilities could move further ahead by incorporating artificial intelligence (AI) and predictive analytics. Here’s a look at how analytics are being used:
- Providence St. Joseph Health (PSJH), which operates 51 hospitals across seven states, has been building analytics capabilities over the past several years. It is transitioning its entire system to one EHR platform and is investing in a data lake for all data sources. The health system is piloting a program that integrates the system’s supply chain database with its EHR to support a pop-up for physicians showing the wholesale cost of an ordered drug or test, along with pricing for comparable treatments. The pilot showed that physicians choose the lower-cost option when efficacy is comparable, resulting in a marked reduction in cost of care.
- Hartford HealthCare (HHC), a six-hospital integrated delivery system in Connecticut, had gone through some of the growing pains typically associated with multiple acquisitions and disparate software systems. HHC leaders determined that an analytics platform could generate data that might help achieve goals related to value-based care, patient experience, growth, quality, safety, and efficiency. Its focus and vision for the past few years has been getting information into the hands of decision-makers for both clinical and financial performance. The health system is building its machine-learning capabilities and is leveraging its standardized data sets to improve patient access and quality of care. In the next three to five years, HHC leaders hope to have both machine learning and AI capabilities in place.
Hospitals and health systems are increasing their use of data sources and are expanding the types of data sets they use for analytics. According to our research, in 2018, the top three external data sources that were integrated into analytics were: health plan claims (73 percent), US Centers for Medicare and Medicaid Services (CMS) data (73 percent), and financial benchmarking data (71 percent). The use of social determinants of health (SDoH) data is expected to grow most in the next three years: While 38 percent of respondents said their organizations use it currently, 77 percent anticipate they will use it in three years.
Analytics is no longer relegated to the IT department. As the health care sector continues its march to a value-based model, the ability to tap into data analytics will likely become even more critical. During the past three years, we have seen bigger investments in analytics infrastructure, resources (dollars and people), and scope. Over the next three years, the majority of our survey respondents expect analytics to become even more critical.