[{"innerBlocks":[],"name":"core\/freeform","postId":897,"blockType":{"name":"core\/freeform","keywords":[],"attributes":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"providesContext":[],"usesContext":[],"selectors":[],"supports":{"className":false,"customClassName":false,"reusable":false},"styles":[],"variations":[],"apiVersion":3,"title":"Classic","description":"Use the classic WordPress editor.","category":"text"},"originalContent":"Health plans now gather and report data for quality reporting, claims reporting and to conduct risk adjustment analysis, but typically these various data collections occur separately, are sometimes duplicative and are uncoordinated, say Deloitte experts. But that will soon all change.

By 2040, health data will benefit from interoperability and will be continually updated, making it easier to discover insights into healthcare and its costs. That\u2019s why health plans should invest in a strategy with an eye toward this future, says Claire Boozer Cruse, a health policy manager with the Deloitte Center for Health Solutions.

\u201cWithin the context of value-based care, there is an imperative for health plans and risk-bearing providers to bring historically siloed data sets, processes and people together in ways that are more seamless for operational efficiency,\u201d according to Matt Siegel, specialist leader in the life sciences and healthcare practice at Deloitte. The idea is to help lower the abrasion level for physicians and bring about high-quality healthcare results, he says.

Deloitte recently conducted a survey of seven Medicare Advantage (MA) health plans and two vendors that provide analytics solutions to discover how their data is being used. \u201cWe use Medicare Advantage as an example, because if anything, it\u2019s a leading indicator, ahead of the market with sole risk capitation, which is the exception to the rule,\u201d Siegel says. \u201cWe have a little lab here with Medicare Advantage.\u201d

Most of those surveyed said their organizations would like to integrate and align risk adjustment and quality functions, but they are still mapping out the strategies. They also said it is difficult to integrate care management data with quality and risk adjustment analysis data. Care management functions at most organizations are separate, sitting in the medical management function, and most often report to the chief medical officer, the survey found. Some of the respondents said the ideal future would include integration of care managers with risk and quality functions, harmonizing the data across all functions.

Indeed, the ideal is not yet reality. \u201cNone of the organizations have arranged their operating model, data and systems to facilitate seamless handoffs between these functions,\u201d the study found. \u201cMost are working to identify overlap across functions, but different individuals lead improvement and change efforts in each area, and most organizations are still determining how emerging technologies will play into their future analytics strategies.\u201d

Over the next five years, Cruse and Seigel see two types of opportunities for health plans to manage their data better, including coordinating the data and processes with an enterprise-wide strategy. This includes automating aspects of data collection and reporting using tools like robotic process automation, natural language processing, and artificial intelligence.

\u201cA lot of plans are trying to race toward this vision, but nobody\u2019s there yet,\u201d Seigel says. One of the biggest problems out there are the legacy systems still in use. These systems process billions of dollars\u2019 worth of claims. It\u2019s not something that is easily changed,\u201d he says.

Seigel says health plans should be looking for ways to test out new strategies in small pilots, \u201cto show the art of the possible.\u201d Do a pilot for a discrete population, for example.

\u201cIn the short term, we advise our clients to get a 360-degree view of their members,\u201d Seigel says.

Right now, very few discrete data sets are coming out of electronic medical records, according to Seigel. The reason for that is in the grand scheme of things, EMRs are relatively new and aren\u2019t well codified and standardized. \u201cClaims might have their warts, but generally speaking there\u2019s a standard. For the most part, you know what you\u2019re going to get,\u201d he says.

Another problem is there is still a lot of the medical record captured via paper, Seigel says. Health plans are still chasing risk adjustment records and records for quality improvement and duplicating their efforts. This is causing provider abrasion, which could be reduced if plans could get smarter in a member-centric way. \u201cPlans should ask themselves, how can we ask for this information just once, instead of multiple times?\u201d Seigel says.

Making use of emerging technology is where plans need to be going in the short term, Cruse says. She acknowledges it\u2019s hard to envision what it will take to get there, but other consumer-facing industries are taking the lead.

One day in the not-too-distant future, quality measurement will focus on what health plans want to measure, not on what they can measure, Cruse says. In the future, plans will be able to \u201csort the junk from the treasure\u201d and use all the data available, including lifestyle and socio-economic data, to focus on the total well-being of a patient.

Cruse and Seigel recently published the study on Deloitte Insights, titled, \u201cCreating a treasure trove of data for health plans: Shifting focus from disparate systems to a connected future.\u201d It can be found here.<\/a>","saveContent":"Health plans now gather and report data for quality reporting, claims reporting and to conduct risk adjustment analysis, but typically these various data collections occur separately, are sometimes duplicative and are uncoordinated, say Deloitte experts. But that will soon all change.

By 2040, health data will benefit from interoperability and will be continually updated, making it easier to discover insights into healthcare and its costs. That\u2019s why health plans should invest in a strategy with an eye toward this future, says Claire Boozer Cruse, a health policy manager with the Deloitte Center for Health Solutions.

\u201cWithin the context of value-based care, there is an imperative for health plans and risk-bearing providers to bring historically siloed data sets, processes and people together in ways that are more seamless for operational efficiency,\u201d according to Matt Siegel, specialist leader in the life sciences and healthcare practice at Deloitte. The idea is to help lower the abrasion level for physicians and bring about high-quality healthcare results, he says.

Deloitte recently conducted a survey of seven Medicare Advantage (MA) health plans and two vendors that provide analytics solutions to discover how their data is being used. \u201cWe use Medicare Advantage as an example, because if anything, it\u2019s a leading indicator, ahead of the market with sole risk capitation, which is the exception to the rule,\u201d Siegel says. \u201cWe have a little lab here with Medicare Advantage.\u201d

Most of those surveyed said their organizations would like to integrate and align risk adjustment and quality functions, but they are still mapping out the strategies. They also said it is difficult to integrate care management data with quality and risk adjustment analysis data. Care management functions at most organizations are separate, sitting in the medical management function, and most often report to the chief medical officer, the survey found. Some of the respondents said the ideal future would include integration of care managers with risk and quality functions, harmonizing the data across all functions.

Indeed, the ideal is not yet reality. \u201cNone of the organizations have arranged their operating model, data and systems to facilitate seamless handoffs between these functions,\u201d the study found. \u201cMost are working to identify overlap across functions, but different individuals lead improvement and change efforts in each area, and most organizations are still determining how emerging technologies will play into their future analytics strategies.\u201d

Over the next five years, Cruse and Seigel see two types of opportunities for health plans to manage their data better, including coordinating the data and processes with an enterprise-wide strategy. This includes automating aspects of data collection and reporting using tools like robotic process automation, natural language processing, and artificial intelligence.

\u201cA lot of plans are trying to race toward this vision, but nobody\u2019s there yet,\u201d Seigel says. One of the biggest problems out there are the legacy systems still in use. These systems process billions of dollars\u2019 worth of claims. It\u2019s not something that is easily changed,\u201d he says.

Seigel says health plans should be looking for ways to test out new strategies in small pilots, \u201cto show the art of the possible.\u201d Do a pilot for a discrete population, for example.

\u201cIn the short term, we advise our clients to get a 360-degree view of their members,\u201d Seigel says.

Right now, very few discrete data sets are coming out of electronic medical records, according to Seigel. The reason for that is in the grand scheme of things, EMRs are relatively new and aren\u2019t well codified and standardized. \u201cClaims might have their warts, but generally speaking there\u2019s a standard. For the most part, you know what you\u2019re going to get,\u201d he says.

Another problem is there is still a lot of the medical record captured via paper, Seigel says. Health plans are still chasing risk adjustment records and records for quality improvement and duplicating their efforts. This is causing provider abrasion, which could be reduced if plans could get smarter in a member-centric way. \u201cPlans should ask themselves, how can we ask for this information just once, instead of multiple times?\u201d Seigel says.

Making use of emerging technology is where plans need to be going in the short term, Cruse says. She acknowledges it\u2019s hard to envision what it will take to get there, but other consumer-facing industries are taking the lead.

One day in the not-too-distant future, quality measurement will focus on what health plans want to measure, not on what they can measure, Cruse says. In the future, plans will be able to \u201csort the junk from the treasure\u201d and use all the data available, including lifestyle and socio-economic data, to focus on the total well-being of a patient.

Cruse and Seigel recently published the study on Deloitte Insights, titled, \u201cCreating a treasure trove of data for health plans: Shifting focus from disparate systems to a connected future.\u201d It can be found here.<\/a>","order":0,"get_parent":{},"attributes":[],"attributesType":{"content":{"type":"string","source":"raw"},"lock":{"type":"object"}},"dynamicContent":""}]

Report: Health plans need to streamline data efforts to reap benefits

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