Guest post by Rose Higgins, president, North America, SCIO Health Analytics
Since they were first introduced, analytics have primarily been used to help healthcare organizations understand past events. In other words, they’ve been informational. That’s important, because as George Santayana is famously quoted as saying, “Those who cannot remember the past are condemned to repeat it.” But understanding what happened, or even why it happened, doesn’t necessarily tell you what actions to take to either avoid or improve upon the prior results.
In 2016, analytics will evolve to show us what will occur if we continue down the same path (predictive), as well as the possible outcomes of several different alternatives (prescriptive), helping healthcare organizations make better decisions.
Here are a few ways the evolution of analytics will manifest itself in the coming year.
- Increasing consumer involvement. In the modern healthcare era, patients/consumers have primarily been content to be passive bystanders in their own care. Analytics will help change this paradigm. For example, population health analytics can show patients the likelihood of an adverse outcome if they don’t make lifestyle changes. At every level, there will be a greater focus on educating healthcare consumers and integrating them as key stakeholders in improving their own health.
- Demand for more precision in analytics. At present, the ability of analytics to stratify risk among patient populations is outpacing healthcare organizations’ ability to dedicate resources to more in-depth patient care. The result is these organizations must make tough decisions on where to focus their limited resources. In 2016, more precise analytics will help answer those questions by breaking down the numbers within those groups to show which patients have the greatest impactability (the ones on whom an intervention will have the greatest effect on their health) and intervenability (those who are willing and able to follow the care plans developed on their behalf). Armed with this information, providers will be able to devote personnel and financial resources to improving the health of the patients they can actually help, while also providing more sensible care to patients where they are unable to make a difference.
- Focus on reimbursement strategies. In 2016, more time will be spent looking upstream to determine what can be done in advance of claims to drive greater efficiency. Analytics will help payers understand which providers are consistently delivering services at a higher level of quality with better outcomes. This knowledge will enable payers to increase the level of “gold carding,” which decreases the amount of oversight or review of processes applied to particular providers who are meeting quality, utilization and efficiency goals. The result is reduced administrative burden for payers and accelerated reimbursements for providers.