Analytics For The Healthcare Industry Essay

1193 Words May 11th, 2016 5 Pages
Analytics for Payers
The healthcare industry historically has generated large amounts of data, driven by record keeping, compliance & regulatory requirements, and patient care. But there is a major paradigm shift in healthcare information management over the last decade, instigated by the birth of electronic medical records and medical informatics. This shift in information management is ongoing, accompanying the new focus on accountable, affordable, high quality and patient-centric healthcare. There is a need for intelligent platform that is focused on helping healthcare organizations embark upon this new era of medical services by leveraging analytics and big data.
Trend in Healthcare Industry and need for Analytics
A new health insurance business model is evolving in a post-health reform environment, and payers have a significant and growing need for analytical tools that help executives and business line managers understand financial, operational, and clinical care performances. To succeed in a post reform environment, payers need to change their business models, including the payment and delivery of care and wellness services.
1. The development of value-based reimbursement methods as the U.S. CMS continues to study a variety of value based payment models like pay for performance (P4P), episodic and bundled payments, and will develop additional regulations to meet its future goals that demand a greater share of provider payments using these models. Payers and providers…

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