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Beyond Claims & Assessments: Understanding Your Population Drives Results

By Tom Halvorson/Tuesday, May 19, 2015


Within healthcare analytics, we are constantly striving to drive action. We pore over data to make meaningful recommendations. Our business demands that we effect change in our health plans, our providers, and more often than not, our employees or members. Administrative claims can tell us a lot about an individual. A health risk assessment (HRA) can tell us even more.
 

But even with these rich data sources, we’re still missing the complete picture. What makes a person tick? What barriers prevent them from seeking preventive care?  Do they prefer to receive information via mail, the internet, or TV ads? What shops and restaurants do they frequent? 

Combining administrative claims with lifestyle segmentation and survey data can help bridge this gap and allow health care decision makers to make the kind of profound discoveries that lead to action. The right tool and analytic expertise are needed to merge these disparate data sets.  

Recently, a health plan client applied Market Expert® — a Truven Health tool that combines Nielsen PRIZM® lifestyle segmentation with our PULSE™ Healthcare Survey and the CDC Behavioral Risk Factor Surveillance System — to its existing members to understand what population segments were the most desirable from a business standpoint. The plan then used the tool to scan its service areas for more people in those segments. Beginning with a solid understanding of its ideal market demographics, this insurer was able to predict the healthcare needs of the unknown individuals and craft programs and perks to target and incent prospective members. The data provided clear insights into the most effective ways to communicate with this market. 

Another employer client wanted to increase HRA participation and act on the results. Using Market Expert, the organization started by parsing its population to understand what participation incentives would be the most appealing. Then it examined the most effective forms of communication for the population segments. This consumer-oriented strategy was successful, creating a substantial increase in HRA participation. The HRA led the employer to discover a previously unknown mental health issue in the population. This insight helped explain recent productivity declines, and the employer was able to design an effective intervention.  

Employers have also used data to increase their Flexible Savings Account (FSA) participation. In one case, the employer and its employees realized a decrease in payroll taxes when the organization effectively educated and encouraged members on the use and maintenance of the FSA. By segmenting their population into meaningful groups, the employer created four different targeted communication methods. Tools like Market Expert enabled this employer to marry demographic and lifestyle data to create target profiles for its employees and their families. Contact us to learn more.

Tom Halvorson
Director, Analytics & Consulting


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