This involves using techniques, tools, and systems that help:

• Gather and compile data points from an array of sources
• Identify and clarify data patterns, trends, changes, and opportunities
• Determine the correct action to achieve the best possible health outcomes

Actionable Insights and Customized Solutions

Our data, compiled from claims and internal reporting as well as vendor dashboards, enables us to have a complete and real‑time picture of our members’ health stories. This provides us with valuable insights that allow us to target unique, customized solutions for each member at each stage of their health care journey. For example, we can help answer questions like:

• Since preventive health screenings can catch problems before they become more serious (and expensive), could members benefit from receiving screening reminders?
• Are there any gaps in the care that members are receiving, such as annual A1C tests, biannual retinal exams, and kidney function testing for those diagnosed with diabetes?
• Can members shift some of their health consultations from more costly settings (such as the emergency room) to less costly settings, such as urgent care centers, retail health clinics, and even telemedicine visits?

With insights from reports, dashboards, trends, benchmarks, and descriptive analysis, we can use what we’ve learned from the past to plan for future outcomes. We can also use techniques like predictive modeling, which can highlight relationships between events and issues and can help anticipate future occurrences.