Anthem Gains Big Data Analytics Insights From the Retail Industry

By: Kelley Katsanos| - Leave a comment


Anthem, a health insurance provider, is looking to the retail industry for big data analytics insights. Because retail companies are skilled at using data collection to create a seamless customer experience, Anthem is drawing on its own expertise to move health care services in a more service- and consumer-oriented direction, HealthIT Analytics reports.

“We need to know what works and what doesn’t in our engagement programs and how to anticipate and predict the best outcomes given very complex characteristics of our membership subpopulations, which span every single segment of the U.S. population,” Patrick McIntyre, senior vice president of health care analytics at Anthem, told HealthIT Analytics.

And the retail industry is setting the foundation for most of the company’s research.

“I would say about 70 or 80 percent of our data science department was actually brought in from the retail industry,” McIntyre told the source. “We wanted to learn from the experts how to engage with consumers and monitor their levels of engagement in their health journey.”

As such, Anthem is gaining knowledge in machine learning, artificial intelligence and natural language processing.

Big Data Analytics Improving Business Processes

By using big data analytics, Anthem can collect insights for population segmentation, identification for messaging opportunities and other services to improve health. Along with gathering patient-generated data from its website, the company is in the process of integrating data from its call centers into algorithms.

Anthem uses a single integrated data warehouse to unite its claims data with clinical data, electronic health records, lab results and other important data sets, explained McIntyre.

Moreover, the company is able to meet patient’s needs in a more personalized and efficient way by sharing data with providers that are part of its value-based payment programs.

“As part of our value-based provider contracting approach, we deliver a set of capabilities to providers called our Enhanced Personal Healthcare Program,” McIntyre told HealthIT Analytics. “This includes reports that identify members with specific conditions or those members that are incurring unnecessarily high costs. The software is implemented onsite in their offices, so they can easily access the data.”

To promote a seamless customer experience, Anthem also has systems in place to prevent its members from receiving duplicate messaging from both the payer and the provider about the same health issue.

Anthem continues to embrace analytics to improve member engagement and gain actionable insights. The company is also using big data and machine learning to detect health care fraud, waste and abuse.

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About The Author

Kelley Katsanos

News Writer

Kelley Katsanos is a freelance writer specializing in business and technology. She has previously worked in business roles involving marketing analysis and competitive intelligence. Her freelance work appears at IBM Midsize Insider, Houston Chronicle's, and AZ Central Small Business. Katsanos earned a Master of Science in Information Management from Arizona State University as well as a bachelor's degree in Business with an emphasis in marketing. Her interests include information security, marketing strategy, and business process improvement.