A QUICK OVERVIEW ON“THE STATE OF PREDICTIVE

ANALYTICS IN U.S. HEALTHCARE”

Original Report by Modern Healthcare and Society of Actuaries Summarized by Yubin Park, PhD

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ABOUT THIS OVERVIEW

• Based on the original report prepared by Modern Healthcareand Society of Actuaries• You can download the original report from• http://www.modernhealthcare.com/assets/pdf/CH105920628.PDF

• Please read the original report for more detailed and comprehensive information

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EXECUTIVE SUMMARY

• Predictive analytics can help healthcare organizations manage various types of risk

• Payers and providers are at different stages of adopting predictive analytics

• Payers and providers face different sets of challenges for implementing predictive analytics

• Both payers and providers agree that the role of predictive analytics will grow further

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EXPANSION OF “RISK”

• The meaning of risk is expanding in the new era of accountable care• Predicting risk is more

important than ever

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Risk

Malpractice

Financialaccountability

StaffingneedsClinicaloutcome

Populationmanagement

SURVEY POPULATION

• Modern Healthcare Custom Media conducted a survey to find out the current state of predictive analytics in the U.S. healthcare• 388 healthcare executives

responded to the survey

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PREDICT CLINICAL & FINANCIAL OUTCOMES

Clinical and financial outcomes are the primary interests

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OBSTACLES FOR PREDICTIVE ANALYTICS

Shows an absence of strategy or urgency around using predictive analytics

Technical challenges are the main obstacles- Incomplete data- Lack of sufficient

technology

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OBSTACLES: PAYERS vs. PROVIDERS

PAYERS• Incomplete Data (31%)• No barriers (15%)

PROVIDERS• Lack of Sufficient Technology

(23%)

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Different obstacles for payers and providers

ADOPTION OF PREDICTIVE ANALYTICS

• 80% of payers are currently using predictive analytics• More than half of providers are not using predictive analytics

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WHAT’S BEING PREDICTED TODAY?

PAYERS• Costs (77%)• Clinical outcomes (57%)

PROVIDERS• Readmissions (62%) • by hospitals and health

systems• Staffing/workforce needs

(50%)• Adverse events (39%)

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Payers and providers use predictive analytics for different purposes

ACCORDION’S PERSPECTIVES

• The boundary between payer and provider is disappearing in value-based care• Payers are already interested in predicting clinical outcomes• Risk-taking providers would want to know about financial

outcomes of their patients• Jointly predicting financial and clinical risks will be the key for

successful and sustainable value-based care implementation

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CONTACT

• Yubin Park, PhD• Chief Technology Officer at Accordion Health, Inc.• [first name] [at] accordionhealth [dot] com

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