Mahi Sall, Advisor, Fintech-Bank Partnerships, Payments and Financial Inclusivity
January 25th, 2023
Mahi Sall is the CEO & Founder of FinXpair, a Berlin-based strategic advisory boutique firm focu[...]
How Data Analytics is Used in Healthcare Insurance?
Jul 25, 2022
Image source: Pixabay
The world is one big ball of unrefined data. Businesses and organizations collect data and convert it into commodities through analytics techniques. Raw data doesn't do much, but with the help of data analysis, it becomes invaluable.
Why is Data Important in Healthcare?
Data is vital in healthcare. For example, HEDIS lets consumers compare different plans against pre-set benchmarks, so they can see how each one performs. Without measurable data, comparisons would be impossible. Data analysis can also be used to prevent and detect fraud.
The goal is to gather as much insight as possible and predict trends to optimize the industry. All industries use data analytics. The healthcare industry benefits the most from these sets of data. It can increase the accuracy of insurance rates, the use of AI in diagnostics, the automation of different processes, and many others.
So how is this data used in healthcare insurance?
Healthcare Insurance Analytics Trends
The main trend is to empathize with clients and make them feel valued. Patients want a proper connection with their health plan providers. They want attention as a person rather than a statistic. Health insurance plans need to be carefully curated to satisfy their needs.
The use of Artificial Intelligence (AI) can ease up the process of analyzing claims data. AI in insurance helps with the Health Risk Assessment, where evaluations and surveys look at average data. This way, health insurance companies can determine which are high-risk patience and reward them when they take steps to improve their lives.
Implementing chatbots and automated answering machines can help possible clients get more information about insurance plans and set up calls in case they need support.
Benefits of Health Insurance Data Analytics
Health Insurance companies that use data analytics have an incredible number of benefits. One of the most important benefits is that they can deliver a personalized membership experience. Companies that are member-centric and not product-centric acquire more clients.
Another major benefit is that companies can identify fraud before it takes place. The National Health Care Anti-Fraud Association estimates over $68 billion in health care fraud costs the USA annually. Now, claims investigators can use predictive analysis to determine malicious or fraudulent behavior.
Health care providers can use predictive analysis to fast-track claims. There is nothing more that people hate than waiting for help. Health insurance providers deal with a high volume of claims, and sometimes it takes more than a month to provide an answer. Predictive analysis helps insurers to analyze a client’s data like their profile and past claims to predict behavioral patterns and determine the outcomes.
Data Analytics Tools for Healthcare Insurance
Companies can use software to gather data from patient surveys and case files. They can also use some programs that curate and analyze specific data depending on a research question. In addition, there is software that can create predictive models to optimize the business.
See: The Average Cost of Health Insurance
Overall, the healthcare insurance industry needs data analysis to understand its clients and optimize their services. Big data provides the essential information to help this industry perform better.
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