Interview with Allen Kamer, Chief Commercial Officer, Optum Analytics

Date: 09.29.2015 | HITC Editor

Healthcare IT Connect’s ‘s Rob Waters sat down with Allen Kamer to discuss provider utilization of data assets, risk management and community analytics.

HITC: Collecting patient data across the care continuum has presented many challenges to providers, integrating claims and clinical data has added complexity to the process. What are some of the main areas you’re seeing providers successfully utilize data assets to support beneficial PHM outcomes to date?

Allen Kamer: Even with the challenges of collecting different data sets across the care continuum, there are many areas where providers can be and have been successful in utilizing their data with their PHM efforts. The key is looking for and finding “actionable opportunities”, or areas where you can have a measurable impact.  A couple of examples where there are positive outcomes:  1) Identifying and actively engaging with patients who have documented clinical evidence of a condition (diabetes for example) but have no diagnosis recorded.  The identification of a non-coded population results in a significant reduction of hospital and ED utilization and an increase in ambulatory utilization;  2) Another good example is transition management from hospital discharge to the home, with the goal of reducing unnecessary hospital re-admissions.  Ensuring hospital admission and discharge data is shared with relevant providers so that they can pro-actively engage with patients prior to and after discharge to ensure things like post-discharge office visits occur within a seven-day period, can have a significant impact on re-admission rates.

HITC: As providers mobilize their organizations to participate in ACOs, they are immediately exposed to the changing dynamics of risk sharing agreements and the need to make data actionable across the healthcare enterprise, has the vendor marketplace been successful in helping providers adapt to this environment?

AK: Vendors have played a key role in helping providers move into a risk or fee-for-value environment.  Historically, providers had little ability to access their own relevant data in a timely manner, and as a result could not perform robust analyses and draw insights to identify which opportunities would allow them to “smartly” negotiate risk-based contracts.  Analytic vendors in particular have essentially changed the game for providers, enabling significant progress in understanding priorities.  Providing products and services with robust analytics, including comparative benchmarking data and predictive models identifying high-risk patients, has been critical for successful ACO enablement.

HITC: Big data’ promises to shift the focus away the clinic to population or community analytics and great strides are being made by a growing number of providers to integrate external sources of data (including mobile, socio-economic and access to services). What progress do you anticipate being made towards these goals over the next 3-5 years?

AK: The desire for providers to be more closely tethered to their patients outside the “four walls” of their hospital or office is accelerating as both the means to do so grow and the necessity of managing risk of patient populations increases.  Truly successful population management will depend on closer connection between patients and their providers.  As numerous digital health solutions emerge that target specific topics like medication adherence, referral management, patient satisfaction, etc., the requirement to integrate those data and measure the impact of those interventions becomes critically important.  We see significant progress occurring in this space, with a select number of vendors offering more open architectures, integrated data, and robust analytics that drive optimal outcomes.

Analytics to Action: Applying Analytics to Improve Patient Health
Panel Leader/Moderator: Allen Kamer, Chief Commercial Officer, Optum Analytics
Anil Keswani, Corporate Vice President of Ambulatory Health Care and Population Health Management, Scripps Health

In today’s world of value-based reimbursement, taking action based on data analytics has become a necessity. Payers are pushing patient risk onto providers’ proverbial shoulders, and the only way to manage that risk is to apply advanced analytics toward interventions.

Dr. Anil Keswani, Corporate VP of Ambulatory Care and Population Health Management, at Scripps Health share Scripps’ experience using analytic tools to determine the populations that need intervention, enroll populations into care management programs, identify barriers to care and compliance and track and manage care management interventions.

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