Healthcare Analytics, Population Health Management, Healthcare Big Data

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Healthcare Financial Analytics, Business Intelligence Market Takes Off

The healthcare financial analytics and business intelligence market is prepped to grow as providers and payers seek new insights into value-based care.

Healthcare financial analytics and business intelligence

Source: Thinkstock

By Jennifer Bresnick

- Financial analytics and business intelligence tools are poised to become the next major area of investment for healthcare providers and payers, predicts a new series of market reports.

As hospitals and physicians deeper into value-based care and risk-based reimbursements, actionable insights from the financial side of their organizations is becoming just as vital for success as clinical analytics and decision support tools.

A number of financial big data analytics tools, including revenue cycle management, fraud detection, risk adjustment, and claims processing offerings, will contribute to a $14.9 billion global marketplace by 2022, says BCC Research. 

“In today’s world, technology is changing rapidly, while innovations are continually being discovered, and they are having a positive impact on the healthcare analytics market,” the report says. “With margin pressures increasing worldwide, analytics are looked upon as a tool to reduce costs.”

“The market is challenged by restraints such as a lack of uniformity in healthcare data, resistance to an IT-based approach by medical professionals, operational gap between payer and provider front, financial constraints, ensuring patient confidentiality and traditional techniques.”

READ MORE: Leveraging Business Intelligence for Healthcare Management

North America will be responsible for approximately half of the anticipated spending as providers slowly work through the obstacles created by poor data integrity, insufficient usability, and lack of familiarity with taking a data-driven approach to clinical and financial operations. 

A separate report from Market Data Forecast concurs with BCC’s prediction: North American healthcare analytics spending will total $7.2 billion by the end of the decade, with providers responsible for the majority of investment in clinical and financial big data analytics.

Driven largely by the regulatory pressures of value-based care, the 15.8 percent compound annual growth rate (CAGR) between 2017 and the middle of the coming decade will bring payers and providers closer together, BCC Research notes.

“Technology is changing rapidly and, as innovations are adopted, they are having a positive impact on the healthcare analytics market,” said Robert G. Hunter, senior editor, healthcare.

“Payer-provider convergence and rising healthcare costs, along with the other market drivers, are creating many opportunities that are boosting the global healthcare analytics market.”

READ MORE: Turning Healthcare Big Data into Actionable Clinical Intelligence

Business analytics accounted for 70 percent of investment in 2015, and is unlikely to lose much ground to other types of products.

Population health analytics are of rising interest, however.  Providers and payers looking to take a proactive approach to managing chronic disease costs will devote more than 28 percent of their anticipated spending to population health products that can merge clinical risk stratification with the identification of cost-saving opportunities.

In a similar vein, healthcare quality management solutions with an analytics component are slated to bring in $1.15 billion by 2022 for developers that can help inform providers, payers, and accountable care organizations (ACOs) about performance on quality metrics and financial benchmarks, says P Market Research.

Payers will continue to invest in tools to monitor their financial health, as well.  With an anticipated 12.2 percent CAGR between 2017 and 2022, the healthcare payer analytics services market will offer insurance companies the opportunity to reduce fraud, waste, and abuse, manage their membership, and coordinate more closely with providers on payments and reimbursement.

A core group of leading business intelligence and financial analytics companies are mentioned in multiple market reports: IBM, SAP, SAS, Oracle, Tableau, Qlik, Information Builders, and Microsoft are all well positioned to continue their growth and dominance in the healthcare industry.

READ MORE: How Healthcare Can Prep for Artificial Intelligence, Machine Learning

However, newcomers and start-ups have plenty of opportunities to disrupt the plans of well-known players.  The advent of machine learning as a powerful force for big data analytics is bringing significant new openings for innovative developers offering advanced financial and clinical analytics tools.

While the majority of existing leaders have also been pushing hard to integrate machine learning approaches into their analytics offerings, nimble new entrants have a promising chance to create lucrative partnerships with eager healthcare organization consumers.

Financial fraud and risk management analytics are expected to see rapid growth within the cognitive analytics and artificial intelligence sector, Markets and Markets predicts, with the healthcare industry consuming a large portion of the $10 billion global, multi-industry market by 2022.

Other reports are even more bullish on the potential for machine learning, cognitive computing, and artificial intelligence to underpin the big data analytics ecosystem of the near future.

The machine learning-as-a-service (MLaaS) category alone is expected to bring nearly $5.4 billion by the middle of the 2020s, Statistics MRC predicted in December of 2016. 

Healthcare organizations are likely to invest in cloud-based and subscription services that require less up-front investment and infrastructure development than building an entirely new machine learning environment on premise.

As the maturity of artificial intelligence and machine learning tools increases and costs subsequently decrease, more healthcare providers and payers are likely to make these strategies a core component of their analytics infrastructure.

Leveraging innovative big data analytics strategies for financial insights and business intelligence will be a vital part of succeeding in an increasingly value-driven landscape.  Both payers and providers are expecting significant returns on these investments by seeing improvements in care quality and lower spending for stakeholders across the care continuum.

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