Payers turn to data warehousing

Historically, payers aggregated data for actuarial purposes or for their sponsoring employer groups’ use. Today, data is in greater demand across the industry.

The demand for sharing data with providers and members is creating a big shift in data warehousing, said Dane Iverson, vice president of information management for WellPoint.

In the past three years, WellPoint has implemented numerous IT initiatives. The payer underwent several mergers and acquisitions, requiring data consolidation data from multiple companies, he said. “Data warehousing becomes very important to put together a fully integrated view of a company’s activities,” Iverson said.

WellPoint also began exploring how to use data to drive clinical programs, he said. It has amassed up to five years of patient data integrated across all platforms, including lab and pharma data, which has resulted in getting a complete picture of its members. The comprehensive patient view has enabled WellPoint to do more interaction with its prevention programs and management programs, Iverson said.

The use of analytics and the breadth and depth of its data has also made it possible for WellPoint to determine what programs are successful, as well as work with members and providers for better clinical outcomes, he said.

The healthcare industry is moving away from the data mart concept to data warehousing with real-time intelligence, said Dean Torres, senior industry consultant for Teradata. Payers are looking for a 360-degree view of their members and providers and want better decision-making at the point of interest, whether in customer service or at a physician’s office, he said.

Nearly 50 percent of payers responding to a Health Industry Insights survey released the first quarter of 2009 indicated they plan to invest or expand their investment in data warehousing to be able to respond to internal and external initiatives. With a rise in quality reporting, health information exchange and electronic and personal health record initiatives, expect that percentage to jump in the 2010 first quarter survey, said Janice Young, research director for Health Industry Insights.

 

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