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Best Practices: Payer Analytics for a Post-Reform Market

Best Practices: Payer Analytics for a Post-Reform Market

This IDC Health Insights report enables payer analytics vendors and payer decision makers to understand the current and emerging issues related to today's executive and individual department users' information and reporting needs. This report also provides a discussion of the need for improved interoperability standards and frameworks to better enable the future integration of clinical and financial information between payer and provider applications.

Evolving reimbursement structures, exponentially growing amounts of data from clinical and financial sources, an increased focus on consumer engagement, and a developing population health approach to disease management are driving the transformation of payer analytics solutions. The U.S. CMS continues to drive much of the need for enterprise-level analytical reports through its continuing regulations and emphasis on new pay for performance (P4P) and other value-based reimbursement (VBR) approaches.

"While today's payer analytics applications provide a comprehensive set of executive-level and individual line-of-business reporting capabilities, there is room for future improvement in terms of the potential for better big data management and the integration of clinical, financial, wearable, remote, and other important sources of healthcare data. Industry- and federal government-sponsored progress on the future development of interoperability standards can be expected to improve payer analytic solution capabilities and decision support." — Deanne Primozic Kasim, research director, Payer Health IT Strategies

Please Note: Extended description available upon request.


IDC Health Insights Opinion
In This Study
Situation Overview
Business Needs
Management Challenges
The Best Practices
Internal and External User Access
Overall Organizational Reporting
Price Transparency
Understanding the Consumer
Supporting Providers
Sales and Marketing
Future Outlook
Essential Guidance
Actions to Consider
Actions for Payer Managers
Actions for Vendors
Provider Reports and Portals
Overall Interoperability
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Synopsis
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