Powering better health care through data analytics

At AmeriHealth Administrators, we use data analytics to make informed and innovative decisions to power better health care for our members.

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 his or her health care journey. For example, we can help answer questions like:

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.

Based on this information, we can serve up meaningful content via email or text message to members who are digitally engaged, no matter where they fall on their health journey. This may be encouraging a member to schedule their annual PCP visit, reminding someone to refill their prescription for antidepressants, or referring a chronically‑ill diabetic to a high‑touch care management program through our Registered Nurse Health Coaches.

These efforts can ultimately lead to healthier, happier employees and cost savings for both you and your members.

Redefining health care delivery to advance equity

Data analysis influences how quality‑based decisions are made at various levels to ensure that care is equitable, effective, affordable, and simple and is helping us advance our mission to improve health equity.

For example, we can create models to predict future hospitalizations and readmissions, the onset of diabetes, and the likelihood of high‑risk pregnancies — issues that affect communities of color at a higher rate — to make more informed decisions to help reduce racial health disparities and improve health outcomes.