Analytics: The game changer in health reform

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As SLG’s health policy specialist, I’m chartered with developing novel ways to apply data analytics to our state government health systems.  If you ask me, it’s the perfect blend of technology and policy - two of my favorite things. However, I sometimes find it challenging to identify the areas within health care where I want to focus my efforts.  There are so many groundbreaking events occurring in this space, and given my (overly) ambitious nature, I find myself wanting to be involved in all of it.  Nevertheless, it’s a good challenge to have; a great one, in fact. As my good friend Chuck always says, “tell me what your business problem is, and analytics can help you solve it.” Chuck’s absolutely right and that very reason is what makes my job so interesting.

While developing innovative ways to solve policy issues is certainly challenging, I can only imagine how states feel.  States are juggling the establishment of insurance exchanges, pursuing information exchanges, setting up accountable care organizations and medical homes, and exploring an entire gamut of innovative service and payment models.  Last week I was reading about Arkansas Governor Beebe’s efforts around the state’s Health Care Payment Improvement Initiative.  It’s evident that public leaders are making health care a focal point on their agendas. Moreover, it’s the first election I’ve seen in which health care, more specifically, Medicaid, is at center stage.  And rightly so; it’s no news to us that health care costs are continuing to rise.  And our state governments are feeling the impacts every day. The good news is that new innovations are emerging through health reform and through progressive leaders that are dedicated to our country’s well-being.  It’s an exciting time in health care, to say the least.

What’s really exciting for me though is that these new service and payment models all function around a single nucleus: data. A lot of it. We’re inundated with information in health care and there’s no doubt that data-driven health care is the way we are headed. Ultimately, we want to be able to use good data at the point-of-care so that we can ensure the best, appropriate treatments. But, there’s more to it than that.  We also need good data for everything before that to ensure access for consumers, coordination of care, and an effective payment method that will incent quality, not quantity.  And we need good data after the point-of-care to help us plan for our patients long-term, prevent negative outcomes, and avoid future costs. In other words, data is critical in helping us to successfully address the iron triangle of health care:

In an ideal world, the iron triangle would be entirely attainable -- access would be sufficient, quality would be excellent, and costs would be contained.  States are working towards those goals. Maximizing the use of their data will get them there.

Enter analytics. This is what really captivates me because when I think about the possibilities of applying analytics to our health care system, the opportunities seem infinite – hence my aforementioned challenge :-).  Data analytics will transform the way we address our health system. In fact, we’re already starting to see it. States are being creative in their approach to the iron triangle;  they’re using data analytics to analyze trends in their population; they’re using it to forecast Medicaid budgets; they’re even using analytics to look at the impact of other government services, such as education, on a citizen’s health.  And, the best part is - we’re just getting started.

With the push from health reform, data-driven health care will move at a rapid pace, and I am excited to see the impacts this will have on the cost, quality, and access of our system. I’ll be developing these themes and others and pointing to positive examples of what states are doing in health care. I’m looking forward to sharing my ideas with you and to hearing yours!

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About Author

Krisa Tailor

Industry Consultant

Krisa Tailor is a Healthcare Industry Consultant in SAS' Health & Life Sciences Global Practice, where she works with healthcare organizations worldwide to address today's most pressing issues with advanced analytics. Follow Krisa on Twitter @krisatailor or connect with her on LinkedIn.

2 Comments

  1. Rick Ingraham
    Rick Ingraham on

    Well constructed thoughts Krisa and welcome to the world of blogging! As you've embraced the Iron Triangle structure, I suggest you also be giving thought to the the TRIPLE AIM. The Triple Aim, initially positioned by the IHI and Don Berwick (founder), became the national agenda when Dr. Berwick was adminstrator at CMS. (Dr. Berwick was also delivered a keynote at SAS's Health & Life Sciences Executive Conference May 2012). While not discounting the importance of access, The Triple Aim of 1.) Improving Health (of the individual or population); 2.) Improving Care (Quality; Outomes; Safety and I wonder "Access"?) and 3.) Lowering Cost is fundamental in all current and proposed federal and state health initiatives. The balancing of such and discovery of new insights that impact performance of all three dimensions is highly dependent upon leading-edge analytics! Something the SAS State & Local Practice, along with SAS Federal LLC and SAS Commercial Health & Life Sciences are all well-positioned to continue its leadership today and in the coming year.

    P.S.......The Air Force Surgeon General's Office includes a 4th "Aim". That being "READINESS" which could easily include "ACCESS".....Hmm, have we gone from a three legged stool, each dependent on the other, to a standard four-legged version, yet when unbalanced quickly becomes broken? Cheers!

    • Krisa Tailor

      Thanks Rick for your comments! It’s funny you mention the triple aim. I have pondered over which model I find more appropriate. I went with the iron triangle because those are the areas I feel that health care payers and providers have control over. The way I see it is that the iron triangle is enclosed in the first part of the triple aim – Improving Health. Improving health is the single goal of any health care system, and the facets of the triangle are simply the key ways that payers and providers can address this goal. And where I believe analytics can make a significant impact. The components of the triangle – cost, quality, and access - are areas that we can undoubtedly impact to subsequently increase the probability of improved health for individuals and populations – but, with no guarantee. Ultimately, much of improving health lies in the hands of the individual.

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