The State of Payer Analytics

Transforming data into a competitive advantage for health plans is more important than ever. Rapid changes in the healthcare industry—such as new risk models, the uncertainty of the Affordable Care Act and game-changing mergers—are placing new obstacles on payers. The mounting pressure to support these industry transformations and the overall delivery of care has led to increased investments in analytics. 

A research study by Fierce Healthcare and MedeAnalytics found payers’ recent analytics investments are primarily driven by their attempt to improve cost and efficiency. Despite these efforts, more than half of payers still struggle with three main analytics challenges:  

  • 68% reported issues with integrating various data sources when collaborating with providers 
  • 56% indicated hurdles in effectively integrating data collaborations 
  • 39% stated that disparate data houses in various locations represented a significant dilemma 

For all stakeholders in the healthcare industry, the power of data lies in its ability to provide insights into all operations, when aggregated into one clear view. To this end, it’s important for payers to invest in an integrated analytics solution that provides an enterprise view into the entire organization, in addition to detailed, functional insights into specific operations. 

With an integrated analytics strategy in place, payers can glean actionable insights to: 

  • Better understand costs and utilization
  • Drive population health strategies 
  • Improve quality initiatives and scores 
  • Increase alignment with provider networks 
  • Enhance employer satisfaction and retention.  

By understanding the root causes of challenges, payers can devise more effective action plans to address them, improve plan performance and understand trends over time. An integrated analytics strategy empowers stakeholders to share best practices through a common platform, minimizing the time and cost managing disparate systems.   

Download our latest infographic to find out more about the state of payer analytics. Then, visit MedeAnalytics Payer Solutions to see how our solutions are designed to help your organization 

MedeAnalytics

MedeAnalytics is a leader in healthcare analytics, providing innovative solutions that enable measurable impact for healthcare payers and providers. With the most advanced data orchestration in healthcare, payers and providers count on us to deliver actionable insights that improve financial, operational, and clinical outcomes. To date, we’ve helped uncover millions of dollars in savings annually.

Leave a Comment





Get our take on industry trends

Introduction to social risk: What healthcare leaders need to understand

September 27, 2024

‘Social determinants of health’ has been a common phrase for decades now, but the term social risk is much less…

Read on...

AI is your new crystal ball: How predictive analytics can reduce denials

September 23, 2024

The idea of having a crystal ball to better understand what claims will be denied is an awesome concept. But one we can’t rely on. Thankfully, we have predictive analytics to take the place of a crystal ball.

Read on...

3 ways to reduce friction in payer-provider relationships

August 14, 2024

The dynamic between healthcare providers and payers has historically been quite strained. Though both parties are interested in improving the…

Read on...

Position your organization for success under CMS-HCC V28

August 6, 2024

The transition from CMS-HCC V24 to V28 heralds a significant shift in risk adjustment methodologies and emphasizes improved accuracy and…

Read on...