Payer analytic strategies to manage population health

In an effort to move away from a volume-based fee-for-service model to a value-based model that rewards quality and health outcomes at reduced costs, health insurance companies are managing population health. Using analytic data, insurers can identify patients with chronic or multiple conditions such as diabetes or cancer, create disease registries, segregate those populations for specialized treatment or follow-up, and monitor the outcomes over time. Key to analytic strategies though is partnerships with providers. Insurers are at an advantage beyond physician practices and to some degree, hospital systems, because of existing claims data that they can leverage to manage populations’ health. For example, WellPoint is investing $1 billion into its primary care initiative in an effort to offer direct care management support and clinical resources, including pharmacy and behavioral health guidance that is not generally feasible for small- to mid-size practices. This webinar will highlight how payers are engaging more members in sustainable behavior changes, as well as promoting greater care management data integration between payers and providers.