A healthcare data strategy is critical for payers
Payer data is the key to multiple areas of insight, including drug utilization, cost trends, and consumer demands and decision-making. Payer data is especially impactful when balancing efficiency and profit with patient and member safety. This level of nuanced decision-making requires aligned data that acknowledges all players involved in health plan decisions—especially drug and pricing information.
Both patients and employers are demanding more value from their drugs and medications, largely in response to increasing costs, more challenges to accessing and navigating care, and more interest in convenience. These pressures are especially severe for demographic groups who face disproportionate economic and social pressures.
To improve their experiences as members, Rivkin recommends that health plans invest in increasingly sophisticated data collection, analytics, and an overall healthcare data strategy focused on equity. This level of data use will require accurate member data as the basis for understanding the needs of diverse populations who benefit from targeted health equity initiatives. But these populations present a challenge in data collection, especially those who fall under the umbrella of ethnic, racial, and economic disparities. Payer investment in data collection and analytics will be a boon to any health equity strategy, as well as overall organizational goals.
These investments will also help support more sophisticated and effective care delivery systems and demonstrable equitable outcomes as you build a robust and resilient organization.
The drug data landscape is changing rapidly
Navigating the drug data landscape is only becoming more challenging. The volume, speed and complexity of drug data is steadily increasing, and even introducing new transactional sources, including retail and patient-generated data.
This dynamic is probably best illustrated in the drug and healthcare data strategy challenges around value-based care contracting for prescription drugs—efforts that have been slowed because of challenges in intra-provider data sharing. Value-based care initiatives will favor players working on common systems where all parties can access a patient’s health history, the drugs they’ve been prescribed, adherence, and their outcomes as information for contracting. Interoperability at this level requires data that reflects a patient path as they move between providers and payers, when they begin new prescriptions, and when they receive a new diagnosis or begin a new treatment.
