Payer analytics

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Payer Analytics


The scene of healthcare has drastically over the years where the healthcare provider and the payer no more hold the power of decision-making. The industry has become highly consumer-based where it’s the patient who can demand a healthcare service that is centered on them, and that too, at a lower cost. All of this has put immense pressure on the industry to reduce the cost of healthcare which has pushed them into providing industry standard practices. That is why, it is needed for the industry to change the dynamic of their business models and work in a new environment. D Cube’s Payer analytics solutions, will therefore, help the payers improve the quality of their services along with tackling various aspects like fraud detection, claims management, clinical predictions, etc.

Why do we need payer analytics?

Affordable Care Act has been one of the driving factor for the various payer analytics solutions. The reduction in the cost of health insurance meant that a lot of adults could now get healthcare at low cost which put the payers at risk. This is why, a change in the business model was needed to understand the risk better and tackle it well. Apart from the affordable care act, the shift in the healthcare industry to become more patient-centric is also one of the biggest reasons for payer analytics. They no longer hold the decision making power and hence, are compelled to provide quality services at lower costs. Given the cost of products in the market these days, healthcare industry is also looking forward to cut down cost at all possible areas to be more profitable. Which is why, it is essential for payers to have an in-depth analysis of their data with the help of data analysis solutions companies like D Cube, and have analytics deployment at the business level.

What are the opportunities that come with Payer Analytics?

Payer analytics, though filled with challenges of integration of large amounts of data and its governance, along with the access of clinical data, is abundant with opportunities as well. Healthcare industry loses about $250 million every year in frauds. They might happen due to errors in data entry, verification error, or faulty claims. Payer analytics help one keep track of all the data which help one combat fraud effectively. It also helps in processing any claims faster and better. Given how the industry has always handled claims manually, it becomes difficult when the number is humongous and keeps on increasing every year. This also leads to fraud. Adopting D Cube’s payer analytics solutions helps process the claims electronically, which not only is a lot more flexible, but also reduces the processing cost to a greater extent.

Payer analytics also helps the organizations engage better with their customers, given how the industry has become a lot more patient-centric over the years. It helps them come up with customized plans for every single patient in order to retain them. It also helps analyze their records to predict the development of nay chronic disease they might have based on their previous records. This can be achieved by various predictive analysis solutions provided by D Cube.  That is why, payer analytics not only helps in combating frauds and claims but also helps retain the customers.


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