Payer Analytics: A Crucial Component in Precision Care

Jun 8, 2017

Future of healthcare

Payer analytics has emerged as one of the most effective tools for arriving at data-driven decisions in the life sciences industry. Traditionally, payers of medical services have had limited access to clinical data which lead to their minimal involvement in cost reduction plans. But with the digitization of health care industry and the emergence of strict medical regulations like ACA, a payer of healthcare services can now have a say in the entire healthcare process.

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Precision Care – Way Beyond Personalized Care

Though often mistaken as personalized care, precision care is an approach which works towards disease management and prevention. It considers various aspects of the genes, the physical environment, and the lifestyle of the patient to predict prevention strategies and understand appropriate treatment process. Although quite similar to personalized care, precision care makes it a point to involve a greater amount of individual data to arrive at highly tailored health solutions. The very premise of precision care is therefore in contrast to the traditional healthcare approach of “one-size-fits-all” where individual patients are hardly differentiated.

Payer Analytics – Bringing Clinical and Financial Data Together

One of the primary steps towards providing precision care is the integration of clinical and financial data. Through data mining and processing, payer analytics provides in-depth insights on every patient. The result is not just business intelligence, but enhanced inputs on how healthcare services can be improved in a focused manner.

Most healthcare regulatory bodies are now focusing on improved patient outcomes which can be easily measured using information technology. Payer analytics merges AI and predictive analytics to get an in-depth analysis of EHRs, CDSS, and revenue cycles, to provide useful insights on areas which need attention. The data gained through payer analytics makes it easier for healthcare providers and policy makers to drive the needed change in the area of precision medicine.

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Industry players like IBM Watson Health, Health Catalyst, and ZeOmega, understand the advantages of payer analytics in delivering better healthcare services. Due to this reason, they are aggressively investing in identifying, assessing, and benchmarking healthcare solutions which will provide precision care without being a financial burden on the patient community.

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