Payers rely on accurate, high-quality data to make health insurance processes more efficient and support improved patient outcomes. However, each beneficiary generates a plethora of data points throughout their care journeys that payers must sift through.
Many payers have turned to data analytics solutions to transform healthcare big data into actionable insights, including Elevance Health and MVP Health Care.
Elevance Health, formerly Anthem, is an Indianapolis, Indiana-based payer serving over 118 million customers across the United States through its affiliated companies. MVP is a full-service insurance entity serving approximately 700,000 customers across Vermont and New York.
Ashok Chennuru, chief data and insight officer at Elevance Health, and Patrick Roohan, vice president of quality and clinical analytics at MVP Health Care, spoke to HealthITAnalytics via Zoom and email to discuss the organizations’ data analytics strategies.
USING ANALYTICS TO DRIVE BETTER OUTCOMES FOR MEMBERS
Chennuru and Roohan both emphasized that their organizations’ analytics approaches center on using data-driven insights to improve outcomes for their members.
However, this process requires that Elevance and MVP generate insights into their customers’ needs, which comes with a variety of challenges.
Roohan highlighted that the COVID-19 pandemic, alongside the mental health and substance use epidemics, has created unprecedented hurdles, such as economic uncertainty. These make improving health outcomes more difficult.
To overcome these issues, MVP’s strategy largely focuses on collaborating with healthcare providers, promoting preventive care, identifying care gaps, and managing chronic diseases. Much of these efforts aim to help educate members on why chronic disease management and preventive care are valuable.
Doing so requires that MVP gather and analyze significant data on its member populations, such as what conditions are prevalent in a community or how cultural differences may impact healthcare attitudes. These insights can then be extrapolated to identify unmet needs in a population.
By integrating both health and social factors data, MVP can work to flag the healthcare needs impacting certain members and contributing to negative patient outcomes.
“People are not going to get preventive care when they don’t have food, and they don’t have housing,” Roohan stated.
He explained that MVP has partnered with insurance company Belong Health to help integrate these data and connect members with resources to address these needs.
Currently, the two organizations are working together to help MVP’s Dual Eligible Special Needs Plans (D-SNP) members access community health providers and resources to tackle persistent social and medical needs.
