Creating an analytics ecosystem to support risk-based contracting

Abstract

Payers are increasingly pressing hospitals and health systems to assume more financial risk through risk-based contracts. However, very few healthcare organisations have the information they need to identify the medical spend on care delivered to patients and to tie the cost of care to clinical outcomes, capabilities that are important to managing financial risk. To successfully manage risk-based contracts, organisations must develop systems that enable insightful decision-making about risk and value. That requires a shift in basic data strategy. Most healthcare organisations today focus on maintaining information systems to manage multiple silos of clinical, operational and financial data. To succeed under value-based care, an organisation must start building an analytics ecosystem for managing patient populations. A healthcare analytics ecosystem is an interconnected set of clinical, financial and operational data sources and analytic capabilities that enable provider organisations to plan, negotiate and manage risk-based contracts. To build an analytics ecosystem, healthcare leaders must translate data into actionable information, leverage that information to create clinical programmes that generate new knowledge, and use analytical tools to turn knowledge into insights that drive strategic decision-making and action.