Within six months of Florence Nightingale’s arrival in Crimea in 1854, the British troops’ mortality rate from disease dropped from 42.7% to 2.2%.
PART 1 OF 3
What you can SEE, you can change: Shedding Light on Care
What Nightengale saw upon arrival – overcrowding, poor ventilation, and general unsanitary conditions – was inadequate, even dangerous care. Her observations of the data available and the steps taken afterward changed care then and since.
Nightingale is famously known as the “lady of the lamp” for doing rounds by lamplight. What we know now, however, is that her greatest contribution was shedding light on care quality and outcomes through data. She was a pioneer of data visualization in medicine.
Today, clinicians don’t just practice medicine, they provide care that prevents chronic illness and improves quality of life. But the principles introduced by Nightingale still apply – what we see in the process of providing care can, if it’s poorly affecting quality and outcomes, be changed. While our healthcare system was designed to serve patients during episodes of need, increasingly stakeholders are focusing on supporting individuals throughout a lifelong health journey. Consumers are demanding this shift – and while a transformation of this nature is not easy for a system that is staggeringly complex, innovations across the care continuum are enabling increased personalization, access, and equity.
Continuity Begets Complexity
Modern healthcare is far from static. Stakeholders across the system are constantly innovating and adapting as new technologies and processes are proven. These stakeholders include the providers we see at the point of care, the health plans involved with reimbursement, the pharmacies that distribute prescriptions to patients, and, increasingly, life sciences companies that develop new drugs and diagnostics.
Few would dispute the need for care continuity. The challenge is how to ensure continuity across billions of care moments that take place in millions of locations overseen by millions more practitioners and designated care coordinators. In this three-part series, we’ll explore what’s at stake, where we’re making progress, and what’s next.
Data Isn’t Esoteric
The Nightingale effect on early healthcare outcomes was relatively swift and pervasive. This is because seeing – and showing – data about what was lacking at the point of care provided evidence that persuaded and united all stakeholders, from the medical establishment to policymakers and governments. Today, when we think of “data-driven healthcare” we can’t consider quality, outcomes, and costs in isolation, but instead as highly interrelated inputs that, once analyzed with software, can help guide each of a person’s care moments.
When Dr. Keith Dunleavy founded Inovalon 25 years ago, he initially saw data from the physician’s
perspective, and soon realized that the right analytics could harness that data to drive both lifesaving and cost-saving insights. Today, clinicians across the healthcare spectrum derive insights from clinical data combined with the same data that is used elsewhere for applications such as quality measurement and refinement of reimbursement models. This data, collected through longstanding relationships with stakeholders from across the healthcare ecosystem, is stewarded and curated for widespread use through the Medical Outcomes Research for Effectiveness and Economics (MORE2) Registry®.
375M+
unique patients
79B+
medical events
MORE2 Registry®
“The Data We Steward”
The MORE2 Registry dataset is the nation’s largest primary source, longitudinally matched dataset containing real-world medical, pharmacy, laboratory, demographic, and clinical data on more than 375 million unique patients and 79 billion medical events across Medicare Fee-for-Service, Medicare Part D, Medicare Advantage, managed Medicaid, and commercially insured populations.
MA VS TRADITIONAL FFS MEDICARE ENROLLEES
2x as likely to be non-white
25.8% lower net worth
12% lower healthcare costs without compromising routine care
Insights in Action: Medicare Advantage
This three-part series will touch upon several meaningful changes enabled by the collective sharing of data as well as what’s still to come. A recent example of change-forcing data analysis is a joint research collaboration between Harvard Medical School and Inovalon on Medicare Advantage (MA), specifically what’s different about MA enrollees versus those who opt for traditional Fee-for-Service (FFS) programs and how outcomes compare for both programs.
Enrollment in MA has grown dramatically in recent years, from 17% of Medicare beneficiaries in 2000 to 48% in 2022. Seeing how MA and FFS enrollees differ can guide policymakers and health plans in understanding who is most likely to convert to MA vs FFS.
Data derived from the MORE2 Registry reveals that MA enrollees are twice as likely to be non-white and have a net worth that is 74.2% of the average traditional Medicare enrollee. In addition, while MA provides comparable primary and routine care to FFS, MA enrollees have more than 50% fewer inpatient stays and 22% fewer emergency department visits than FFS enrollees and overall healthcare costs for MA are 12% lower than for similar FFS beneficiaries.
This and other data underscore the significant role that MA can play in promoting health equity, given the relatively socioeconomically disadvantaged population that it serves. While this is data collected for many purposes over time, by now applying to one of today’s greatest challenges, addressing health inequity, we will certainly see care change.
”The findings provide new resources for policymakers and healthcare administrators to improve the delivery of value-based care programs, address health inequities, and improve health outcomes for all beneficiaries.
Michael Chernew, PhD,Health Economist and Professor at Harvard Medical School
Looking Ahead
By unlocking data amassed over decades across billions of care moments, we can expose gaps in care and drive meaningful changes that make healthcare more accessible, equitable, and effective. This is a journey, however, and it’s far from over. In fact, we’re just getting started.
The goal of this brief series, which continues with part two, “Where data meets the point of care,” is to celebrate the progress being made across providers,
Payers, pharmacies, and life sciences companies so that stakeholders can learn from one another to achieve their individual enterprise goals. Ultimately, however, we are all beneficiaries of this data-driven approach, whether that’s manifested in better care when we’re a patient, improved outcomes as a health plan enrollee, access to specialty medicines from the comfort of our own home, or rapid approval of a new drug that could save the life of someone we love.
