2019 Healthcare Payer Analytics Market Trends Report with Profiles on 18 Leading Vendors - ResearchAndMarkets.com

The "2019 Healthcare Payer Analytics Market Trends Report" has been added to ResearchAndMarkets.com's offering.

This report reviews the current state of the market, categorizes the different kinds of vendors and solutions, and describes in some detail vendors' capabilities for meeting the needs of their payer customers. It focuses on the solutions that are enabling greater payer efficiency, cost and quality measurement, contract management, and network optimization.

Historically, payer analytics vendors used claims data almost exclusively. This data source, although time-lagged, supports a robust set of applications that meet many performance improvement needs for different kinds of payers. More recently, payers have begun adopting analytics technology to support the transition from fee-for-service (FFS) to value-based care (VBC).

The variety of pay-for-performance (P4P), pay-for reporting (P4R), and risk- and revenue-sharing programs with providers has caused payer organizations to invest in applications that help balance cost and quality through a better understanding of their members' healthcare needs and risks. These applications need combined provider and payer data to deliver insights to users, and allow payers and providers to share a common understanding of cost, quality, and utilization performance described in value-based care contracts.

For now, cost, quality, and utilization reporting remain the common thread among organizations using analytics tools, looking to achieve immediate goals like improving HEDIS measures and HCC scores, finding fraud, waste and abuse, and controlling the total cost of care and identifying cost drivers. Payers are also turning to advanced analytics to predict a range of outcomes, costs, and events.

However, capitalizing on the value these tools provide remains a challenge. Payers find that current analytics tools are excellent at identifying areas for improvement but need engaged clinicians and members to take appropriate action. The offerings also need to do more to offer non-analysts the actionable insights they need to make measurable changes on their own.

This comprehensive report provides an overview of the payer analytics and reporting market and evaluates offerings from 18 leading vendors, classified under three categories based on data focus: claims analytics, clinical analytics, and technology-enabled services vendors. Each profile includes an assessment of the vendor's strengths and challenges, plus detailed descriptions and evaluations of both the product capabilities and market execution across 21 categories.

Key Topics Covered

CHAPTER 1: EXECUTIVE SUMMARY

• Key Takeaways

CHAPTER 2: PAYER ANALYTICS TECHNOLOGIES AND APPLICATIONS

• Analytics Technology Review
• Moving from Descriptive to Prescriptive Analytics and Reporting
• Advanced Analytics for Payers
• Putting Reports into Practice
• Data for Payer Analytics
• Claims Data
• Integrated Clinical and Claims Data
• Emerging Data Sources
• Payer Use Cases
• Cost and Utilization Management
• Quality Management
• Care Management
• Risk Management
• Payment Management
• Predictive Analytics
• Value-based Healthcare
• Network Optimization and Provider Engagement
• Market Expansion

CHAPTER 3: PAYER ANALYTICS VENDORS

• Vendor Types
• Inclusion Criteria
• Claims Analytics Vendors
• Clinical Analytics Vendors
• Technology-enabled Services Vendors
• Vendors to Watch
• Chilmark Bearing - Healthcare Payer Analytics
• Vendor Letter Grades
• Detailed Vendor Ratings
• Product Capabilities Ratings
• Vendor Product Capabilities Ratings
• Market Execution Ratings
• Vendor Market Execution Ratings

VENDOR PROFILES

• Arcadia.io
• CareEvolution
• Cerner Corporation
• Certilytics, Inc
• Change Healthcare
• Clarify Health Solutions
• Cotiviti
• Health Catalyst
• HealthEC
• IBM Watson Health
• MedeAnalytics
• Medecision
• Milliman
• Optum
• Philips
• SCIO-EXL
• SPH Analytics
• ZeOmega
  

TABLES AND FIGURES

CHAPTER 1: EXECUTIVE SUMMARY

Figure 1.1: Payer Analytics Vendors and Vendor Types

CHAPTER 2: PAYER ANALYTICS TECHNOLOGIES AND APPLICATIONS

Table 2.1: Data Sources for Payer Analytics

Table 2.2: Healthcare Payer Analytics Use Cases

CHAPTER 3: PAYER ANALYTICS VENDORS

Figure 3.1: Vendor Types and Vendors

Table 3.1: Claims Analytics Vendors

Table 3.2: Clinical Analytics Vendors

Table 3.3: Technology-enabled Services Vendors

Figure 3.2: Chilmark Bearing - Payer Analytics

Table 3.4: Vendor Letter Grades

Table 3.5: Product Capabilities Harvey Ball Key

Table 3.6: Product Capabilities Ratings

Table 3.7: Market Execution Harvey Ball Key

Table 3.8: Market Execution Ratings

For more information about this report visit https://www.researchandmarkets.com/r/o211c3

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