Healthcare Analytics, Population Health Management, Healthcare Big Data

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Healthcare Payers Are Keen on Analytics, But Feel Unprepared

Healthcare payers recognize the importance of strong data analytics competencies, but they don't feel confident that they can cultivate the right skills.

Healthcare payers and data analytics

Source: Thinkstock

By Jennifer Bresnick

- Big data analytics is a top priority for the majority of healthcare payers in 2019, but relatively few feel adequately prepared to succeed with becoming data-driven organizations, according to a new poll from North Highland.

Eighty-three percent of payers participating in the survey believe analytics is an important strategic priority for the upcoming year, but only 17 percent are confident that they have the skills, technologies, and processes in place to truly leverage health data effectively.

Just 38 percent believe their data analytics problems are easy to solve.

The large gap between the desire to improve and the perceived ability to do so may cause problems for payers who are hoping to compete in a challenging insurance market while simultaneously equipping providers with the insights they need to succeed with value-based care.

“While business executives across all industries are optimistic about growth, there’s a disconnect, with the majority not feeling prepared to tackle strategic priorities,” said Alex Bombeck, President and Managing Director of North Highland. 

READ MORE: UX, AI, and Amazon: Top 5 Healthcare Predictions for 2019

“Businesses can overcome a lack of readiness by infusing better business intelligence and applying longer-term visioning to create a more informed decision-making process that can advance other organizational priorities while effectively engaging employees.”

The lack of strong data analytics competencies may hamper payers as they attempt to address their other priority items, the report indicated.

Eighty-four percent of participants are hoping to become more consumer-centric and improve the experiences of their members – a task that requires payers to deeply understand their customers by analyzing clinical, financial, and socioeconomic data. 

It is perhaps no wonder, then, that just 14 percent of payers feel as if they will succeed with this goal in 2019.

A similar number of insurance companies (80 percent) are looking to reduce waste and improve operational efficiency in the coming year, another initiative that will depend heavily on the ability to gain visibility across the organization’s data and use predictive analytics to support positive decision-making.

READ MORE: Big Data to See Explosive Growth, Challenging Healthcare Organizations

None of the respondents – zero percent – believe they have the skills in place to accomplish this mission.

Healthcare payer priorities for 2019

Source: North Highland

The barriers to success are familiar ones, the report noted.

“As with many other industries, people and resources and knowledge and skills are the two most common barriers to addressing strategic priorities,” the brief said.

Seventy-six percent of payers are facing talent shortages, and 70 percent are concerned that they don’t have the knowledge or skills to succeed. 

Perhaps more worryingly, however, 72 percent of respondents said they simply do not have a clear strategy in place to guide their digital transformation efforts, and 65 percent say they lack focus.

READ MORE: Less Than 50% of Healthcare CIOs Have Strong Trust in their Data

“The concepts of culture and change are often at the foundation of many of the operational performance issues we’ve observed with clients,” said Tina Ehrig, Managing Director and Global Healthcare Lead.

“To enhance a plan’s operational performance, we need to start with assessing these challenges through the lens of cultural change.”

Those changes may need to begin with reassigning tasks to different segments of the enterprise.  When North Highland asked about the highest priorities for the IT department, operations, and sales and marketing, the results seemed somewhat surprising.

Ninety percent of respondents said their IT department is focused on product and service innovation, while just 80 percent reported that analytics was a top priority for IT. 

Just 75 percent are leveraging their IT staff to implement operational improvements – despite the fact that 86 percent think that better supply chain analytics will be a key component of boosting efficiency.

In contrast, 90 percent of ops departments are looking at analytics improvements, yet only 79 percent are prioritizing operational efficiencies.

Only sales and marketing appears to have their eye on the ball: 86 percent of payers said their sales teams are working on improving customer experiences, and the same number are using sales and marketing to foster organic business growth.  Just over three-quarters consider data analytics one of their highest priorities.

Without getting to grips with data analytics across all departments, however, it is unlikely that many of these initiatives will succeed, the report reiterated.

“Think beyond data for risk and population health management, and shift your focus to member insights on the service side of the business,” the experts urged.  “Consider the ways that member-facing data and satisfaction scores can enable the product and service innovation that will move the needle on member experience.”

“Member-facing data can offer much-needed direction on the type of engagement customers are eagerly awaiting.  Powering consumer experience transformations with data strongly supports the outcomes payer organizations are looking for: fantastic consumer experiences that cultivate growth and paths to operational efficiency.”

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