RESEARCH

BI a Competitive Mandate for Healthcare Payers

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IT professionals within the payer side of healthcare (i.e. insurers, health plans, and benefit administrators) are constantly bombarded with requests for data about employers, providers, claims, and health plan members. IT decision makers facing these requests should explore Business Intelligence (BI) to better serve the analytical needs of their organizations.

Industry Pressures Create Deeper Analytic Needs

Healthcare payer organizations are under pressure to become more efficient. On one hand, the government, employers, and patients are pushing to stop the double digit premium increases of recent years. On the other hand, an aging population is raising the costs of providing healthcare services.

To remain competitive, healthcare payers need to find new ways to be more efficient and to better manage their provider networks. This requires attracting new customers, managing their costs more effectively, enhancing productivity, and minimizing revenue losses due to fraud schemes. All of these initiatives require the analysis of massive...


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