Payers, providers seek remedies to value-based care challenges

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Healthcare analytics popularity grows along with focus on performance

The healthcare analytics market is growing, thanks to the provider push for value-based care and improved performance, according to a Chilmark Research report.

The push to value-based care may have been the business driver of the healthcare analytics market. But, these days, healthcare analytics vendors are offering products that extend well beyond that primary use case.

That's according to the "2019 Healthcare Provider Analytics Market Trends" report by analyst firm Chilmark Inc., which provides a snapshot of the healthcare analytics market through an analysis and ranking of 23 vendors.

Based on the study, Chilmark believes while value-based care initiatives serve as the main driver behind analytics adoption by provider organizations, vendor analytics products are evolving to enhance performance across multiple areas of healthcare, including operational, financial and clinical.  

That said, healthcare organizations are only tapping the surface of what analytics can do, according to Brian Murphy, research director at Chilmark, based in Boston, and one of the report's authors. But vendors appear to be preparing for that use to only grow.

"There's more opportunity to do more things with a lot of these products than people are currently doing," Murphy said in a recent webinar.

Healthcare analytics come in two flavors

Chilmark bucketed healthcare analytics vendor products into two categories: what Murphy called mainstream analytics and advanced analytics. 

About 90% of the use cases for healthcare analytics fall into the mainstream analytics category. Mainstream analytics are descriptive and backward-looking, and they rely on EHR and claims data to provide an overview and summary of a healthcare organization's performance, according to Murphy.

There's more opportunity to do more things with a lot of these products than people are currently doing.
Brian MurphyResearch director, Chilmark

Mainstream analytics enable providers to understand performance based on past data, so they can understand where they are and change their processes to perform better in the future, Murphy said. They can also provide some basic predictive capabilities, such as readmission risk, and can recommend specific actions, such as steps a clinician can take to improve quality performance, he added.

As providers move toward value-based care and the focus on quality increases, so does the provider demand for analytics tools that can track performance. Mainstream analytics gives providers a window into what is happening within their organizations, helping identify potential areas of concern or areas of inefficiency within their clinical operations.

"They are adopting [analytics] often initially to get a handle on how they're doing or to prove what they're doing in respect to value-based care arrangements," Murphy said.

Now, they are applying analytics to use cases that stretch beyond value-based care. According to the report, providers turn to analytics to help reduce Medicare readmissions and to meet the goals of state-based managed care and Medicare programs.

Advanced analytics focus on prediction

While most have experience using mainstream analytics, healthcare organizations are looking for more predictive and prescriptive capabilities in advanced analytics.

Chilmark described advanced analytics as a broad category that includes AI, machine learning, natural language processing and data that doesn't fit neatly into a relational database.

Use cases include using machine learning for data aggregation or illness predictions and using natural language processing for referrals analysis and optimization, care pathway improvement and adherence optimization.

"More and more vendors are beginning to use natural language processing to extract data from notes to add to these analytics data stores, but it's certainly far from being uniformly available at this point," Murphy said. 

Eventually, advanced analytics could offer extensive predictive capabilities that mainstream analytics can't, such as determining the possible courses of illness for a patient or the possible outcomes from different interventions on a per-patient basis, according to Murphy.

While advanced analytics currently don't have significant use among healthcare organizations, it's an area that's poised to grow and mature significantly over the next three to four years, Murphy said.

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