How Data Analytics is Transforming Healthcare

Data analytics is one of the most important tools healthcare organizations can use to improve healthcare. There is so much data available – clinical, financial, research, etc. Turning the data into useful information provides insight that would otherwise be invisible. 

Revenue is declining, and costs are increasing, so it is imperative to be effective and efficient in everything we do – analytics can help. Identifying efficiencies that can streamline operations is the key to maximizing reimbursement and reducing costs. The challenging aspect is that providers must have access to vital information to identify these areas for improvement. When progress is measured, inherently - it improves.

Claims Data

• Using claims data to determine patterns can answer some key questions, such as:
  What claims can be paid without employee effort?  If the correct information and payment are captured upfront, claims can be processed and paid without human intervention.
• How many claims are denied or require edits?  You can utilize data to analyze these claims and reduce the time spent by staff working through denials.

Up-Front Collections Data

Are there opportunities for financial clearance automation? Task automation, where applicable, can improve accuracy and reduce time so providers can complete claims faster and cleaner. Using real-time data to understand which patients are/are not cleared financially can help staff make the most informed decisions on the front end.

Payer Data

Analytics can help practices understand payer differences by utilizing various Payer-specific data. This data can determine the Payer Mix, Gross Collection Rate by Payer, and what % of Revenue each Payer contributes to the organization. This breakdown gives visibility to how payers compare, which can provide helpful information during contract negotiations.

Provider Data

We can also utilize data to understand provider productivity further. Using the production data from the practice management system or E.H.R. to build a monthly scorecard can provide insight into areas for improved production, utilization, scheduling opportunities, etc.

There is no doubt that healthcare data analytics is here to stay. If you have access to reports but lack the real-time intelligence to make informed decisions, please contact us. We would be happy to discuss healthcare analytics solutions with you.