My last post addressed a general overview of the entire healthcare analytics continuum - from foundational data integrity to true prescriptive analytics. At the end of that post I promised to dive into each layer with a bit more detail. So today's post will deal with the most important layer in the continuum - foundational data integrity. After all, without high quality, fully integrated and enriched healthcare data, any analytics exercise will be flawed at best.
Recent polls by GE and Accenture show that big data analytics is a priority for almost 90% of organizations within healthcare. Data is an essential tool for market participants that want to increase share while improving the quality of customer deliverables. And, in the not too distant future, healthcare providers and stakeholders that implement an analytics strategy will excel in clinical quality and prevention of operational bottlenecks.
In many fields, it is common to hear the terms "platform" and "application" tossed around interchangeably. The confusion is understandable because, for a non-technical person, platforms and applications can provide similar initial results. The two concepts are quite different, though, and it's important to understand which one your organization needs.
I’ve spent my entire professional career in healthcare - 24 years and counting. The vast majority of that time was spent in the cost containment segment, in particular PPO network management strategies and out-of-network repricing and negotiation strategies. For years, I passionately believed that the products and services I represented were providing value to my clients by reducing their paid claims expense. Over the last 5-7 years of my tenure in that segment of the business it became more[...]
The more time I spent in the field this past spring, the more I heard from both existing and potential clients about the need to analyze plan allowed amounts against Medicare pricing equivalencies. It's no secret that employers, brokers, consultants, TPA's and health plans are all considering various reference-based or Medicare-based pricing strategies in their plan designs. Whether considering a total PPO replacement, a narrow network strategy complemented with Medicare pricing wrapped[...]