Healthcare payers want clinical analytics to provide real-time, evidence-based information that can help their members receive appropriate care at an appropriate cost. But they don't think that either their data or the current generation of retrospective, claims-based analytics tools is ready for the challenge, according to a focus group study of payers and providers conducted by HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society in Chicago, and sponsored by San Diego-based Anvita Health. Payers' limited expectations regarding the benefits that clinical analytics can bring in terms of either quality or costs "are likely shaped by the presence of some significant obstacles, including the frequent lack of a common language for analysis and a perception that clinical analysis is cost-prohibitive," Anvita Health CEO Richard Noffsinger tells FierceHealthPayer. In addition, many survey respondents reported that they don't have appropriate staffing, including programmers, to evaluate data fully. However, "those hurdles are not insurmountable," notes Noffsinger. And the survey demonstrates that payers are beginning to appreciate that clinical analytics can help them manage risk "as reimbursement structures begin an expected shift toward an outcomes-based focus and away from volume of care," he adds. White paper [1]
Links:
[1] http://www.himssanalytics.org/docs/Clinical_Analytics.pdf