Big Data and Financial Support in Healthcare

Initially considered the forte of research agencies and digital companies, data analytics is now a raging demand across sectors, including healthcare. The big game-changer has helped organizations become competitive.

According to a McKinsey survey, companies that leverage Big data and analytics effectively boost their productivity and profitability by 5-6 percent, giving them a competitive edge.


Why is Big Data Vital in Healthcare?

Despite the increasing excitement regarding the prospects of big data analytics in investments and healthcare, most facilities are still lagging. A recent survey by Dimensional Insight has revealed that about 56% of healthcare facilities and hospitals lack a long-term analytics plan and proper data governance.

The risks of inadequate data governance include records duplication, missing deserved reimbursements, financial benchmarking challenges, and other operational hurdles. Big data can effectively fix these!

As patient care becomes more complex, the lack of proper analytics makes it increasingly challenging to deliver safe and quality patient care with better outcomes. Due to data inaccuracies and mismatches, most healthcare facilities have experienced data disparities between their accounting and clinical departments.

Fortunately, big data comes through in the following ways:

  • It helps deliver high-risk patient care
  • Cuts costs for healthcare providers by at least a quarter
  • Limits human errors in medical services
  • Innovates healthcare solutions

The ABC of Big Data


Here’s an overview of the ABC of big data:

Health Disparities

Artificial Intelligence (AI)

Everyone is turning to AI or is beginning to master machine learning. Organizations need algorithms. Some may not understand why but can’t bear missing out on a revolutionary trend.

Business Intelligence

Companies require data analysis technologies and strategies to extract insights from their bulk data. You need data to run your business, but this simple fact is a continuous challenge.

Customer Intelligence

Like well-organized IT assets and leading tech teams, customer focus is a vital consideration for any company. The customer must sit at the core of every business endeavor.

Data Intelligence

Information is considered the new oil for healthcare organizations, but it’s similar to crude oil deeply hidden somewhere. Data intelligence can help understand how business information is structured, where it is, its connection, and the actual quality.

Financial Intelligence

If you’ve reached this level, making investment decisions is more effortless. It would be best to consider the customer database a company asset to provide a sound basis for decision-making regarding BI, AI, and tech investment.


The Potential for Big Data to Enhance Revenue Cycle Performance and Cash Flow

The health sector is transitioning into a value-focused industry, and organizations are always looking for ways to boost healthcare delivery and results while optimizing their bottom line. Here are the practical ways that big data can improve your cash flow and financial performance:

  • Improved revenue cycle – Big data grants access to vital revenue indicators like denial rates, claim rejections, and net collection rates. This way, you can identify areas that need improvement. Furthermore, the data can inform staff training and awareness on common billing errors.
  • Weakness identification – Data analytics can help you note the areas your practice is falling short. You’ll then partner with organizational leaders to create strategies to solve the loopholes.
  • Strategy setting – Identifying areas that need improvement and having precise metrics to measure them can help you set practical goals.
  • Performance assessment – This is probably the most evidence reliance on data analytics to enhance practice performance. Indicators like payer mix and total revenue offer a holistic view of your practice’s financial health. You can also evaluate if you’re meeting targets or achieving goals.
  • Identifying growth and expansion opportunities – Through data analytics, you can locate areas indicating growth opportunities. For instance, by viewing encounters distribution, you’ll identify the common treatments or conditions. This allows for data-driven decisions when making company expansion maneuvers.
  • Troubleshooting urgent issues – Big data and analytics can help you identify problems like No Response or Denied claims that require prompt attention for a positive cash flow. An excellent data analytics software can detect payment delays and their causes.
  • Time savings – Part of your billing involves accessing accurate and centralized revenue data sources. Data collection and analysis will free up valuable time that you would otherwise have spent collecting the data.



How Big Data Aids Risk Scoring

This healthcare analytics subset requires organizations to quantify complex but vital measures for running the organization. Although the industry’s primary objective is to improve health for each member under care, providers and payers alike are still slow in adopting Risk Scoring capabilities that offer a holistic portrayal of member health.

Popular Risk Scoring structures compute only a single Risk Score per member. The models assess members’ relative health but don’t offer specific, actionable health improvement and disease prevention insights.

However, the landscape is evolving with the emergence of advanced analytics and big data tech. As the innovations challenge the status quo, they’re fueling Risk Scoring capabilities’ evolution towards offering specific, actionable insights. Instead of computing one Risk Score per member, calculations based on disease state let you understand and address each member’s medical needs.

Machine learning predictive analytics is helping healthcare providers compute illness-specific Risk Scores to identify those with the highest chance of hospital admission. Those who adopted the methodology early are already reaping the rewards, reducing admissions and readmissions while diminishing member medical costs and improving their health.


Big Data Key Performance Indicators (KPIs)

These KPIs should simplify how CFOs and executives monitor the future of their healthcare facilities – but it’s not always the case. You may be tempted to track every bit of data in your hands, which can distract you from reporting to predict future performance and crucial forecasting.

Refining your KPIs using big data lets you mine datasets for insights that will influence vital business decisions to enhance your performance and impact your bottom line.

Effective KPIs must be:

  • Quantifiable and well-defined
  • Thoroughly communicated within your healthcare facility
  • Crucial to your goals
  • Relevant to your line of business

Achieve Better Results Using the Clinify Health Approach

Clinify Health is focused on enabling provider independence and financial stability for healthcare providers operating in underserved communities. The leading value-based care enablement partner empowers success through customized practice transformation and access to actionable business data.

Please reach out for more information or to request our demo.

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