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eQHealth Blog

Solving the Rubik’s Cube of Payer Data

By Mayur Yermaneni, Chief Strategy and Growth Officer, eQHealth Solutions 

For many health payers, making sense of their data is like trying to solve a Rubik’s Cube. They have all of these individual data points. But the more they twist and turn them with their analytics, the further away from the goal they seem to get – and the more frustrated they get with the process. 

Anyone who has learned to solve an actual Rubik’s Cube with regularity, however, knows the key is to understand and recognize the patterns that lead to success. 

The Rubik’s Cube health payers are currently facing the mountain of incredibly rich data they’re sitting on right now. America’s Health Insurance Plans (AHIP) says the typical regional payer processes $8 billion in claims each year. Each of those claims houses a wealth of interesting data. Yet the challenge they face is how to aggregate and parse it in ways that enable them to take actions that will improve health outcomes and reduce costs. 

But it isn’t just the volume of data that makes it so valuable. It’s the unique view it offers into member/patient health. 

Even today, in the electronic age, providers, for the most part, only see the clinical, laboratory, and pharmaceutical data captured by their own office, facility, or health system. Any care that occurs outside their boundaries is often a mystery (even though by now it shouldn’t be), leaving holes in their understanding of the member’s health. 

Read more at Healthcare Business Daily News here, or register for the webinar by following the link below.  

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