“If it can’t be measured, it can’t be managed” is rapidly becoming the operating philosophy of the health care industry, aided in large part by more extensive use of electronic health care records, mobile applications and the growth of population health management. Using health care analytics – sometimes called business intelligence – researchers and consultants are mining clinical and claims data to discover gold standards and establish best practices for prevention, treatment and self-care and, ideally, help reduce waste, abuse and fraud.
The goals are simple but have remained elusive: Identify what works, what should be charged and how the cost should be shared, so maximum value can be derived from the $2.7 trillion being spent on health care. Potential beneficiaries include all of the five P stakeholders: providers, patients, payers (insurers), policymakers (legislators and regulators), and, of course, purchasers (employers), whose health plans cover nearly six out of 10 employees and their dependents.
