The AHIP 2022 Conference
America’s Health Insurance Plans (AHIP) is a national organization where healthcare insurance providers work together to create a better and more affordable healthcare coverage for Americans. Annually, AHIP hosts a conference where thought leaders across the nation convene to discuss and share current advancements and best practices within the healthcare systems of the United States. This year’s conference was held in Las Vegas, Nevada, and was AHIP’s first live and in-person conference since 2019, with attendees like Aetna, Blue Cross and Blue Shield, Cigna, Healthfirst, Mayo Clinic, and CVS Health. Also in attendance, to connect with industry leaders and gather key insights, were Divurgent’s Andrew Wells (Senior Director of Business Development), Bismoy Beura(Vice President of Client Services), Debbie Rieger(Payer Principal), Krystyna Chmura(Director of Client Services), and Steve Weichhand (Executive Vice President of Client Services).
The Future of Healthcare is Data
Many topics were covered during this year’s conference, including healthcare equity, healthcare technology and innovation, and aligning health and social care. However, the most prevalent topic surrounded data and its importance in creating an accurate picture of patient populations. From the giant shift towards telemedicine, to driving real-time decision making through analytics, the key takeaway from this year’s AHIP conference proves to be that the future of healthcare is its data.
Healthcare payers and providers have realized that digital access and virtual care will become a standard way of care access in the very near future. During the COVID-19 crisis, there was a huge shift towards telehealth for receiving healthcare. According to an ASPE report, Medicare beneficiaries alone grew telehealth numbers from 840,000 visits in 2019 to a record 52.7 million visits in the following year. Clinical research participants who received the COVID-19 vaccine also utilized telemedicine, which provided additional audit trails and data points for researchers. Telemedicine also has the potential to include more diverse and traditionally underrepresented populations, providing the inclusion of more accurate, real-world data of the historically under-enrolled demographics in FDA approval submissions.
This shift towards virtual care has increased healthcare convenience for patients, establishing the need for a data collection and health metric tracking process. Providers would be able to make evidence-based, actionable decisions with this real-time data from the patient and population levels. And with a push for Value Based Care and Pay for Performance Contracting, having accessible data would increase provider accountability of patient outcomes.
Further payer and provider benefits of real-time data include:
- Mitigating risks
- Enhancing healthcare quality and delivery
- Better management of member populations
- Achieving health equity
- Enabling an increased personalization of patient experiences
Overcoming Healthcare Data Challenges
Quickly becoming the healthcare industry’s new focus, data is foundational for the key metrics that can improve our nation’s health outcomes. But collectively moving a process into the space of data can come with challenges. Two important challenges the industry must overcome are the current lack of standardized data collections and disorganized data warehousing and infrastructures.
Standardize Data Collections
Without a standardized process, it becomes difficult to understand the gaps in care and to recognize where the opportunities for public health interventions lie. Furthermore, having a streamlined and up-to-date claims data extraction allows for both payers and providers to uncover and close these care gaps.
Providers can take more immediate action with patients when real-time data is available; however, most claims data is already lagging on an average of six weeks. During this time, care gaps have either been naturally closed or the data is no longer relevant. Having complete and timely claims data sets will provide proof that clinical guidelines and standards of care are being appropriately measured and obtained.
But we can’t wait for the perfect data process to be handed to us before starting a data collection initiative. Until an overall standardized industry process exists, it’s important to continue working with the data that you do have. Providers can also begin collecting data such as those that capture Social Determinants of Health (SDOH): food security, social economic status, ethnicity, affordable housing, etc. This SDOH data collection is meaningful for both the individual and overall community health status. And when applied to an individual’s personal health data, payers are provided with significant data that would improve their healthcare delivery and member experience.
Organize Data Warehousing and Infrastructures
Having a well-organized data warehouse and infrastructure will provide aggregated data from multiple sources (such as electronic medical records, claims data, financial data, supply chain data, etc.) onto an analytics platform. But the challenge for payers and health systems is maintaining the current data warehouse and analytics platform while also focusing their efforts and resources towards the ever-growing needs of improving healthcare delivery and outcomes.
Sustaining this build of a proper infrastructure while maintaining excellent care becomes challenging for health systems due to a limitation of resources. Solution providers, such as Divurgent, can offer subject matter expertise to organizational leaders on change management and can support the implementation of an effective team to build the infrastructure and additional dashboards needed to meet clinical goals.
With these shifts toward virtual care and telehealth, and their consequential need for data, we must plan for these challenges while simultaneously ensuring patients are being served the highest quality of care during a seamless transition into a digital world. For these to be true, we need to effectively and proactively be managing data and transforming data. In the end, the data must paint the correct story regarding your patient population to know where your efforts and resources should be directed and to stay ahead of issues.
About the Authors
Andrew Wells is Divurgent’s Senior Director of Business Development. He brings over 10 years of experience working in healthcare management and is specialized in outpatient, inpatient, and health plan operations. With Divurgent, he focuses on the growth of the client services department while supporting new sales directors, territory expansions, market penetrations, and client relationships. To learn more about Andrew, visit him on LinkedIn.
Krystyna Chmura is a Director of Client Services, Payer at Divurgent. She is passionate about improving population health outcomes, increasing health equity and expanding access to affordable healthcare. Krystyna has 10 years of professional experience, with expertise in clinical research, pharmaceutical product lifecycle, pharmacy benefit management, and payer markets. Krystyna holds a Bachelor of Arts in Biology from Rutgers University and a Master’s degree in Public Health from the Keck School of Medicine of the University of Southern California. To learn more about Krystyna, visit her on LinkedIn.
Amanda Sorg is the Marketing Content Writer at Divurgent. She focuses on strategizing and creating impactful, meaningful content that drives the connection of readers and clients to the Divurgent community and offerings. She received her Bachelor of Arts degree in Psychology and Anthropology from the University of North Florida and holds certifications in Digital, Content, and SEO Marketing. To learn more about Amanda, visit her on LinkedIn.
