Data strategy and analytics for health care payers and TPAs

Health plans • Pharmacy benefit managers • Third-party administrators • Employers

You are not just paying for care – you’re coordinating it. Whether you're a community health plan, an employer or PBM, or a large integrated payer-provider network, you’re looking to promote better health and lower costs in your population. We understand the challenge that data present: how do you best-leverage data and analysis to ensure that great care is appropriately orchestrated across providers and settings?

From big-picture choices like whether and how to share more risk with your providers and incentivize patients’ choices, to metric selection and surveillance, to the details of care management tools and helping the providers that treat your covered population make better use of data – strategies for making more of your data can help.

HORIZON partners with health plans, employers, and others involved in coordinating care to develop data strategies, identify what’s driving low-value care in their networks, understand why certain patients seek out-of-network care, evaluate and improve care management plans, as well as begin to tackle wide range of other issues and make data work for your organization using a thoughtful, scientific approach.

Examples of some of the capabilities we can offer you include:

• Conducting analyses to help you design your networks, and using data to shed light on why some patients may seek out-of-network care
• Helping you understand the variation in clinical practices among your providers, quantifying the potential benefits of greater alignment and barriers to greater alignment and adopting best practices
• Helping you predict which patients in your networks are at greatest risk of slipping through the cracks – during handoffs, or in between all-too-infrequent primary care visits – and ending up in the hospital
• Conducting analyses to support contract negotiations, such as helping you identify which providers may be good candidates for increased risk-sharing or global capitation
• Identifying clinically-cohesive subgroups and other ways of segmenting your population that will make your patient engagement efforts work better and cost less
• Preparing streamlined assessments of clinical and economic evidence to support formulary decision making
• Describing what your patients’ care teams look like (e.g., which providers have they seen in the past 6 months?) vs. what they should look like

Learn more about us

Visit the rest of our site for more details on our approach, capabilities, and team. Contact us to learn more and schedule an initial consultation.