An expert guide for health plans digitizing big data and improving productivity. Spreadsheets are useful and can be a very powerful tool in the right hands. But are they really the best your health plan can do to analyze and organize complex or big data? That’s the question many in the industry have begun to ask as improved data analysis tools hit the market, many of which feature cutting edge technology like automated workflows and predictive analytics. Spreadsheets have been an industry staple for nearly four decades, and while they certainly hold a place, it’s questionable whether or not they hold a place in process digitization. Process digitization refers to the automation, or conversion, of data into digital units that are utilized by technology to automate business processes. “Process digitization can… radically accelerate and transform data analytics — and business models,” writes Robert Brown of the Center for The Future of Work. While it may sound simple in theory, digitization of processes has “disrupted entire industries,” notes Brown.
Spreadsheets are Not a Technology SolutionIf it seems like process digitization is inevitable in the healthcare sector, that’s because it is. As health plans are increasingly tasked with high-level processes like transparency, digital records management, and adhering to strict process oversight, automated digital workflows are required. Data collection tools do more than just allow a health plan to meet regulations – they also allow healthcare organizations to reap the rewards of big data analytics. In the past, spreadsheets have been useful for handling limited data sets. But the reliance on spreadsheets alone comes with many problems, and they shouldn’t be considered equivalent to a technology solution. Spreadsheets further the issue of data siloing within an organization. Additionally, a spreadsheet cannot support the current industry need to make quick decisions with precise information. That’s because spreadsheets:
“The reliance on spreadsheets alone comes with many problems.”
- Lack visibility into data (which is often hidden in complex cells)
- Cannot process large data sets due to software limitations
- Limit the ability to compare side by side numbers
- Make it difficult to track changes or versions (needed for historical analysis)
- Lag on calculations and other analytical tool functions for complex data spreads
- Are not conducive to embedding external analytical models
- Disparate systems that don’t “talk to one another” (a sign that process digitization has not yet occurred)
- Systems that no longer accommodate your unique business processes
- Reliance on the legacy analytical tools built into outdated systems, which are often weak or more trouble than they’re worth
Powerful Analytics for System-Wide TransparencyModern technology allows for faster, more robust analytics than spreadsheets alone. Going digital with big data isn’t just about integrating a data collection tool into your workflow. In fact, optimal data analysis is dependent on system-wide transparency. That’s where a comprehensive payment integrity platform like Pareo® proves useful for health plans, because it offers an integrative, enterprise platform. Healthcare IT News recently published an article in their next-gen series that focuses on the future of financial management. According to the article, “Healthcare organizations require sophisticated analytics to perform a deep dive into their information. … As we move closer toward value-based care, analytics become even more important, along with the ability to bring in clinical information to support the revenue cycle.” Additionally, expect artificial intelligence to boost predictive analytical ability, according to Healthcare IT News. Making the case for adapting this technology, next-gen revenue management tools offer health plans the ability to reduce the cost to collect and provide access to information for members, healthcare providers and third-party vendors.
Pareo® Provides Big Data Process DigitizationPareo is positioned to integrate completely with health plans, offering process digitization to claims identification and recovery systems. Data is culled and integrated into workflows that proactively assist with FWA prevention. The process offered by Pareo offers complete visibility and transparency to a health plan. We are able to digitize data and improve productivity by offering the following 3 benefits:
- Advanced Analytics and Predictive Modeling – Pareo can improve operations by driving smart overpayment recovery and prevention with claims analysis and predictive modeling. Intuitive design, custom queries, smart-capture claims, advanced query development and rules-based electronic claims processing (predictive analytics) offer a huge benefit to clients.
- Fraud Waste and Abuse Analytics – The strongest compliance processes aim for prevention first, which requires process insight. Pareo provides analytics to clients that allow a range of interventions and to refine monitoring and compliance processes.
- Data Warehousing – With Pareo, data can be integrated from multiple sources and flow into a single platform, offering clients accurate information. Through Pareo’s Enterprise Data Warehouse, multiple sources of information are handled in one platform, offering clients an agile and on-demand experience.