Driving through the Rear View Mirror

14 Oct Driving through the Rear View Mirror

Rear View (rîr’vyū’) n.

1. A mirror, such as one attached to a motor vehicle, that provides a view of what is behind.

I always enjoy people talking in futurity about the day when there will be “data liquidity” within the health care industry. They talk of a day when information will be pervasive, available, translatable, portable, and accessible to the people who need it the most to make essential decision. I smile knowingly as I hear the starry eyed “Health 2.0″ers talk about data in terms of flow, mythical health exchanges, and “data utility layers” that while found every in other industries remain in absentia within health care.

Health Care is one of the few data intensive industries that has not enjoyed widespread adoption of analytics information management tools. Even when we do, it is most a retrospective analysis of the distant past.

The reason for my sanguine chagrin is that I have been to that party, am currently fighting the good fight, and will continue to break my back against the institutionalized information constipation that remains the standard operating procedure within health care. We have been very fortunate to work with some of the most progressive thinkers in the space, some of the most advanced technologies, and some employers that have enough understanding to want to actually want to look at their own data and more importantly begin to develop interventional services around their findings.

Several months back, there was a nice article from the George Pantos is the executive director of the Healthcare Performance Management Institute. While self-interested in nature (they do after all represent the interest of all the performance management companies, consultants, and vendors), it highlights the complete irony that employers who are paying for health care cannot even get their own data to understand and know how to best manage their health care costs. Can you imagine if your credit card company refused to provide you with the information on your charges?

But even in the rare event that you do get it, and you do have the tools to analyze and understand it, the view you are getting is most often in the rear view. I can see what I historically did and make a best guess about what I need to do in the future. Unfortunately, most employers have no guidance nor insight into where the road is going to go, how to avoid those painful curves or steep climbs, or when to expect the next respite ahead.

At Crossover Health, we are working every day to help provide employers at least the very basics of health analytics so they can at least see where they have been. We hope in the near future to lift their sights to at least see and understand what is happening in real time. But more importantly, we hope to be a part of the future when we can squarely point them forward to not only see the road ahead, but to drive with confidence to their chosen destination. We believe, that will be the power of next generation health care.
Read more: http://www.post-gazette.com/pg/10317/1102927-432.stm#ixzz1ajGGnn6X

HealthCare Performance Management

“This process of analyzing claims data is at the core of a business strategy called Healthcare Performance Management (HPM). Unfortunately, many businesses are walled off from their medical claims data. Insurance companies often refuse to share it with health plan sponsors. The insurers’ resistance is not always consistent with their clients’ own business interests. If a company doesn’t know how it is spending its health dollars, it will be less able to question ever-increasing premiums.

That has to change. Policymakers should require carriers to give employers access to claims data that are rightfully theirs. Texas provides a model for reform. Two years ago, legislators granted employers access to select privacy-protected employee health information, including total paid claims, their employees’ general census data, and total monthly premiums.”