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In Health Care, Big Data Can Lead to Better Health

It has been a year since President Obama convened a workgroup to review our nation’s big data and privacy policies. The findings of this workgroup were not surprising...
March 31, 2015
“Big data will become an historic driver of progress, helping our nation perpetuate the civic and economic dynamism that has long been its hallmark… the digital revolution continues to work for individual empowerment and social good.”
No industry has so much to gain (or lose) from this “historic driver of progress” as the health care sector. Already there are big winners when it comes to big data and health, including consumers, payers and providers.  

Consumers love it.

When it comes to consumers, the data-driven wave is ready to crest.
Consumers are plugging in to personal health trackers at record rates. According to a report by Juniper Research, the market is projected to grow 366 percent by 2017.

These consumers are tracking eating and physical activities that contribute to an overall improvement in their health. (Surely this is what the president’s workgroup envisioned when it spoke of “individual empowerment”.)
In many cases, there is an actual monetary value when someone puts their health data to work.
I personally benefited from using big data to manage my health while working with a previous employer.
The employee health benefits plan encouraged me to log my personal health data, like BMI, cholesterol levels, etc., and in return I received discounts on my health insurance premium. I saved hundreds of dollars per year by knowing my numbers and tracking them to hit my health goals.
I wasn’t the only consumer who loved it. Most of my employer’s 17,000-plus associates participated in the program to receive the financial incentives.

Payers are embracing it.

My employer benefited from the data-driven employee health program, too. A healthier workforce lowered costs for insurance and decreased associates’ need for expensive procedures. 

This employer-sponsored program isn’t too dissimilar from programs being initiated by payers.
For example, UnitedHealthcare and Kaiser Permanente offer their members a big data-driven incentive program powered by Welltok’s CafeWell platform. The platform allows consumers to participate in different challenges to learn healthy habits and earn incentives for health care products and services.
The model the program is based on shows that as consumers participate in these challenges they improve their health, decreasing the total cost of care for each life the payer covers. That’s money in the payer’s pocket and it’s why payers are increasing embracing these types of programs. It’s a win for them and a win for their customers.
However, while preliminary results are very positive, these programs are still so new we have to wait to determine ROI of these efforts over the long run.

But is it a winning recipe for providers? 

Providers can win with big data too, but it takes a thoughtful approach.

When we start talking about big data and providers, thoughts instantly go to population health management (i.e., policies and programs that affect change in health determinants to produce healthy outcomes in a given community).
That’s why adoption of big data in provider settings is a bit more complicated given the volume-based compensation model that providers currently depend on. 
A short-sighted hospital CFO might keel over at the suggestion that the organization get into the business of using big data to improve population health, especially because those CFOs know their business has historically depended on the traditional volume-based compensation model that population health initiatives seek to stem. But those days are numbered, and it would be a mistake for providers to take a wait-and-see approach.
In fact, just a few weeks ago, the Obama administration unveiled an ambitious plan to rein in health costs by paying for value rather than the volume of tests and procedures, beginning with Medicare. 
Providers can learn from a groundbreaking initiative in Maine, whose big data program is improving population health while sustaining volume.
St. Joseph Healthcare, Bangor Beacon Health Accountable Care Organization and other regional players formed a coalition to share consumer data, in the form of electronic medical health records, across their systems and feed the data into a shared predictive analytics tool. They combined records of Maine’s nearly 1.3 million residents and then applied sophisticated modeling software to predict which patients were most likely to make a visit to the ER, have a stroke, suffer a heart attack or get type 2 diabetes.
Health systems in the same market aren’t known for playing well together, so it’s truly stunning that they came together for the benefit of the health care consumer. But the consumer wasn’t the only one to win. The hospitals participating in the pilot won too.
Already, the tool has led to a reduction in hospital readmissions – which, as compensation models evolve, will increasingly be money out of the provider’s pocket – and being able to predict health issues means that providers can more accurately market preventative services that can continue to drive volume.

Where we go from here?

The Obama workgroup’s report ends with an acknowledgement that the insights must be considered in other administration policy priorities.

Health care administrators must also begin to integrate big data initiatives in their strategic plans or they’ll be ill-positioned for the wave of new consumer health engagement strategies and compensation models.
[Photo credit: JustGrimes via Flickr]

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