Skip to main content
person looking at a tablet of population health data

What is population health analytics? A brief explanation

Population health analytics is transforming patient care in disease prevention, care delivery, enhancing patient engagement, and more. It’s also helping payers and their provider networks gain a holistic view of member populations while supporting quality improvement, care intervention, and case management programs to deliver patient-centered care and reduce costs.

What is population health analytics?

Population health analytics is the review, study, and data dissection of information that “brings significant health concerns into focus and addresses ways that resources can be allocated to overcome the problems that drive poor health conditions in the population.”

Healthcare analytics is the collection and review of vast amounts of data to provide actionable insights developed through analytical disciplines to drive fact-based decision making. These decisions improve care planning, management, outcomes measurement, and post-care learning.

Those studying population health management need vast amounts of data to analyze and derive meaningful insights. They must be able to access standardized, accurate data – including claims data, patient sociodemographic information, and clinical data – to perform appropriate population health analyses.

Effective population health management requires ongoing monitoring, action, and data collection, all operating in a cycle that informs payers and health systems in supporting their populations’ wellbeing. Some providers and payers are already working together to apply population health analytics and make informed decisions to better manage specific patient populations. This helps each group understand care gaps more thoroughly and better focus resources on underserved populations.

Benefits of population health analytics

Population health analytics can benefit various initiatives across healthcare. Payers may monitor their members to better address barriers to care, while life sciences companies can use these analyses to support new drug development and post-market surveillance.

Some of the top benefits of population health analytics include:

More informed quality improvement initiatives

Detailed data on member interventions, outcomes, and care gaps allows health plans to better target patients for future interventions. Population health analytics gives plans easy access to member and provider contact info – facilitating more efficient and effective outreach. Combined with information on disease prevalence and risk profiles, health plans can better forecast their expected healthcare utilization and costs.

Improved resource allocation

Having a better understanding of patient care gaps and organizational performance benchmarks allows payers and providers to focus on where their resources can have the greatest impact. They can use population health data to compare outcomes by patients in rural zones versus urban areas, or to identify diagnoses trends in specific geographical areas.

Predicting patient risk

Population health data can be stratified according to risk profiles to inform initiatives for quality improvement. Payers and their provider partners can use this information to guide their interactions with at-risk patients.

Population health analytics empowers them to drill into specific details, per patient, for better efficiency in the care management environment. This means they can better collaborate on delivering the care patients need most, especially those at risk of chronic conditions, diagnoses of mental health issues or substance abuse, and future hospitalizations.

Address barriers to care based on social determinants of health

With population health analytics, payers and providers can determine how pre-existing conditions are affected by SDOH. For example, some populations face barriers to care such as lack of transportation, poverty, domestic violence, and food insecurity. By analyzing which populations are faced with SDOH factors, payers are better able to mitigate risk and work with providers to reduce the impact these factors may cause.

When SDOH factors are better understood, healthcare organizations can better drive health equity initiatives together. This results in a more cost-effective healthcare ecosystem that recognizes common barriers to care and actively helps patients overcome their treatment obstacles.

Performance benchmarking

Although population health analyses often help payers and providers collaborate, this information can also be used to measure how performance stacks up amongst different organizations. This is particularly important for payers quality measurement performance, and can be helpful for providers as they monitor star rating performance as well.

Population health insights can be segmented by member populations to compare outcomes against national and regional benchmarks. The detail goes as far as measuring disease prevalence and risk profiles among common populations and common areas.

By understanding and being able to demonstrate the quality of care provided compared to other organizations, health systems can better negotiate value-based programs and continue improving performance on quality measures. The patient experience also benefits as well, both in terms of the better care they receive and in the ability to compare organizational performance measures themselves, which often influences a patient’s choice in plan or provider.

Get the most out of your population health analytics

Looking at population data is more than just a one-and-done initiative. Effective population health management means constantly diving into data, monitoring and collecting it, and taking action on it.

Population health analytics allows health plans and providers to continually inform their next steps in supporting quality initiatives, patient health outcomes, and resource allocation. Health plans can identify, predict, and prioritize at-risk populations to provide member-specific interventions for clinical and non-clinical needs – while improving their quality measures and healthcare economics.

However, it’s patients who have the most to gain. As payers and providers continue to unlock the benefits of population health analytics, the patient experience throughout the care journey will further improve.

For more about health population analytics, check out our blog on measuring population health.

Inovalon and design®, Inovalon® are trademarks of Inovalon, Inc.

By Inovalon