Customer Experience

Analytics in Health Plans: From a Clinical Focus to a Consumer Focus


Historically, health plans have focused a lot of their analytic talent, and a lot of their analytical work on the clinical informatics area within the organization. So, organizations that are devoted to uncovering trends and disease, and devoted to helping people become healthier, take the right steps to make sure that they’re doing what they need to maintain their health on a positive track trajectory, or to improve their health if they’re already sick.

Increasingly, as we march towards climative consumerism, health plans are devoting a lot of this analytical talent and their resources, and building analytical toolsets that are devoted to things that are much more consumer-centric in nature, so the softer things that health plans might not have focused on in the past. Things like consumer preference, willingness to engage in a management program about their health, willingness to potentially convert into a program where they’ll be working on a regular basis with a health coach to improve their diabetes, or to improve their asthma, or to just stay healthy.

These are all the things that health plans are actually refocusing their deep and rich analytical talent around, but not enough to just build individual‑level insights about folks, and then move forward with strategies to deploy against them. Having a rich, and robust, and integrated approach to understanding these unique attributes about a member is going to be critical to success in engaging them, and to managing the way that they use the system.