18 Dec Top 10 Health Payers and Data Stories for 2019

In 2019, we saw a wide range of payer-related news stories that showcased how this specialized arena is leveraging data in new and unique ways. There were also a number key studies and research pointing to the true value of data for payers.

Thankfully, we have compiled the top 10 health payer-related stories that were featured on the IMAT blog in 2019. Hopefully, these stories will serve as inspiration for the development of your payer data strategies in 2020.

1. GAO Report: Need for Social Determinants of Health Programs to Treat High-Cost Medicaid Beneficiaries
   The Government Accountability Office (GAO) recently issued a report about how SDOH, such as a lack of stable transportation or housing, is making it difficult for states and managed care organizations to treat the most expensive Medicaid beneficiaries.
2. AHIP: Health Payers Are Key Drivers to U.S. Economic Growth
   According to a 2019 report from America’s Health Insurance Plans (AHIP), the healthcare payer and insurance industry are key drivers of state economies across the country through both job creation and by expanding access to care and payer coverage.
3. Blue Health Intelligence Playing Critical Role in Using Data to Understand Healthcare Costs
   Health Care Cost Institute (HCCI) announced a partnership with Blue Health Intelligence to integrate data from 36 independent Blues across into its national database and contribute to research on healthcare costs and spending.
4. Health Payers: Schema Versus Data Lakes and Social Determinants of Health Efforts
   In the new SDOH frontier, many payers are most likely considering the options between schema/structured and data lake environments for making these datasets more actionable and valuable to their efforts. Both options have their opportunities and challenges.
5. PwC Study: Data Analytics Critical for Advancing Social Determinants of Health Efforts for Payers
   A recent study by the PwC Health Research Institute is calling on payers to leverage data and analytics to make informed population health decisions, and predictions about what healthcare services these patients may need in the future considering their overall medical history.
6. Alignment Health Plan to Offer Concierge Services and Social Determinants of Health Benefits
   From transportation to appointments to grocery benefits to companion care, Alignment Health Plan will offer qualified Medicare Advantage members a wide-range of SDOH benefits in 2020.
7. Optima Health Addresses Food Security in Social Determinants of Health Efforts
   In an effort to address the more human elements of SDOH, Optima Health is launching a new program that lowers financial barriers to healthy food options, and increases overall food security.
8. Aetna Launches Precision Medicine Efforts to Improve Health Outcomes and Decrease Costs
   Aetna launched a new precision medicine program that embraces breast and ovarian cancer testing program using the BRCA gene test. It is also implementing a genetic information privacy policy, becoming the first health plan to require quality credentialing of genetic testing labs.
9. Health Payers Bringing Human Element to Social Determinants of Health Efforts

With SDOH in the payer arena focusing on “whole person” care, several payers are embracing innovative approaches to this emerging frontier – often bringing in more of a human element.

10. Anthem Enhances Health Access and Behavioral Health Management
    In an effort to enhance overall health addressing behavioral health within its beneficiary populations, Anthem announced that it is acquiring Beacon Health Options, a behavioral health management company that serves beneficiaries in all 50 states.

IMAT Solutions’ robust health data management platform is helping payers to better align claims and clinical systems to inform and drive new SDOH and population health initiatives, as well as help to measure the outcomes of these efforts.

To learn more about how payers can best harness their data for improved analytics, interoperability and outcomes, please click here.