Health plans have more data and analytics than they typically know what to do with. The challenge is to use new types of data and advanced analytics like artificial intelligence and machine learning to derive insights and actionable information that all stakeholders – healthcare consumers, providers, and payers – can use to facilitate access, improve outcomes, and reduce costs. It’s no wonder that Data & Analytics consistently ranks high on the annual HCEG Top 10 list of challenges, issues, and opportunities facing healthcare leaders.
On Wednesday, April 28, 2021, HCEG Executive Director Ferris Taylor moderated “Use Data to Uncover Insights and Create Actionable Strategies that Address Member Needs,” a webinar hosted by our partner World Health Care Congress with the following healthcare leader panelists:
- Sherri Zink, Senior Vice President, Chief Data Officer at BlueCross BlueShield of Tennessee
- Shawn Wang, Vice President of Enterprise Data Science at Anthem
- Mohammad Jouni, MS, Chief Technology Officer at Wellframe
This post shares highlights of some of the insight, expertise, and experiences shared by the above executives during the webinar. Access a recording of the webinar here and hear from the panelists themselves at the [specified recording time] listed with each of the session highlights presented below.
Strategic Focus on Using Data & Analytics to Find New, Actionable Insights
Ferris Taylor kicked off the discussion by asking panelists to introduce themselves and to share, from a strategic point of view, a quick overview of how they are using data and analytics to find new and actionable insights.
Leveraging Social Determinants of Health
Sherri Zink shared her organization’s focus on improving member engagement by leveraging different data across multiple silos – including social determinants of health data from 3rd parties – to help providers engage with plan members on a more holistic basis. Listen at [00:04:41]
Anticipating Member Needs & Personalizing Interactions via Workflow
Shawn Wang offered how his health plan is better anticipating members’ needs and personalizing interactions via existing workflows. Listen at [00:07:30] for more on:
- Importance of embedding data and AI insight into workflows
- Personalizing member interactions with personalized care plans, personalized news, and personal topics that address member needs.
- Reducing overall burden by removing complexity from staff member jobs
Earning Trust of Members By Giving Them Something in Return
Mohammad Jouni shared how technology partners can support health plan member’s medical needs and administrative needs as members are interacting with health plans during other customer service events. Listen at [00:09:37]
Uncovering Insights & Actionable Information: Opportunities, Challenges, & Points of Pain
Panelists shared information on the pain points and challenges that their health plan or health plan customers have addressed or still trying to address in making data and analytical tools actionable to support the relationships between the health plan, the consumer, and the provider.
Supplying Business Partners with Meaningful, Actionable Data
Sherri conveyed the importance of taking advantage of teachable moments during member interactions with customer service, capturing and leveraging unstructured data presented during interactions, and making data and analytics available in downstream systems and to provider partners. Listen to Sherri at [00:12:22]
Importance of Thinking About Data from Standpoint of Member, Not the Organization
Many health plans organize their company by functions and not around the member. Shawn shared his thoughts on the importance of a cohesive, end-to-end process, using data from the member’s viewpoint and not from an organizational standpoint, and embedding data and analytics into organizational workflows. Shawn shares at [00:17:30]
Importance of Member Trust & Trust in the Process
Mohammad talked about the need to earn member trust and how vendors who establish trust with plan members can do a lot for the member that health plans or providers might otherwise not easily accomplish. Listen at [00:33:33]
Applications Having Greatest Impact from Data & Analytics
Sherry shared insight on what applications are having the greatest impact from improved data and analytics, the need for member trust, and how Net Promoter Scores are impacted. Listen at [00:36:13]
Major Impact on Reducing Duration of Pre-Authorization Process
Shawn shared how high-volume, complex back-office processes like pre-authorization and other utilization management functions benefit greatly from improved data and analytical capabilities. Listen at [00:40:48]
Vendor Interactions Impact on Health Plan Member Satisfaction
Mohammad stated that closing gaps in care is one of the areas seeing the greatest impact from data and analytics. He noted how new insights on member needs and member interactions with 3rd party vendors and their offerings are positively impacting plan member satisfaction and trust. Listen at [00:43:55]
Integrating New Data into Analytics and Tools Provided to Providers and Consumers
Ferris stated that there are lots of different tools out there and that it seems like data and tools are multiplying every six months. Ferris asked: As health plans, how are you integrating new data into the analytics and the tools that you’re providing to your consumers?
LISTEN to Sherri’s thoughts on the following topics at [00:46:55]
- Insight on downstream operational systems and legacy applications
- Making sure data produced in upstream systems is available in downstream operational systems
- Mapping clinical data, financial data, administrative data – structured & unstructured – on-premises & cloud-based
- Integrating 3rd party data – particularly social determinants of health
LISTEN to Shawn’s thoughts on the following topics at [00:49:43]
- Organizing and consolidating data – Key to scaling integration capabilities
- Capturing insight from audio interactions & acting on that insight near real-time
- Updating analytic models frequently and timely deployment to downstream systems
Attendee Questions on Using Data & Analytics to Create Actionable Insight
Panelists had an opportunity to respond to questions from webinar attendees. Listen in at [00:53:44] to hear panelist responses on questions pertaining to the following:
- Co-developing a data & analytics strategy with business partners
- Defining and ranking use cases across all business units
- Accommodating member/patient communication preferences
- Example of addressing high-utilizer of ER services
- Avoid taking a cookie-cutter approach
Panelists Leaders Share One Piece of Advice on Leveraging Data & Analytics
Ferris concluded the discussion by asking panelists to share one piece of advice on the broad topic of data and analytics. Listen at [01:01:58] for panelists responses on the following topics:
- Ensure alignment with overall strategy & think through the end-to-end process
- Start with the outcome you want to achieve
- Demonstrate value early on
Opportunities for Insight and Interaction with Healthcare Leaders
For more insight and information on the challenges, issues, and opportunities facing healthcare leaders, subscribe to our newsletter and check out these on-demand webinars from our partner World Healthcare Congress.
You may also consider joining other healthcare executives and thought leaders for one or more of HCEG’s Focus Area Roundtables. We currently have roundtables on the 2021 HCEG Top 10+ focus areas highlighted in the graphic below and are adding more.
Complete this short form to share which focus areas you are interested in and how you’d like to participate with the HealthCare Executive Group.