While it seems there’s not much we can all agree on these days, there is one thing that brings everyone together – complaining about the state of healthcare. From the challenges of finding the best healthcare provider to the skyrocketing costs of health insurance, these are the issues that unite us.
However, leading health insurer, Anthem, is focused on solving these problems for its members. One way we will transform healthcare and create a more personalized, seamless consumer experience is through better analysis of all available data sources and the use of artificial intelligence (AI) and emerging technologies. “At Anthem, we’re focused on value-based care,” shared Venugopal Yerubandi, the company’s Analytics & Insights Executive Advisor. “We want to ensure that our members are receiving the highest standards of care and we want to connect them with the providers who can deliver on that promise.”
Yerubandi and his team are connecting members to providers by putting data to work. By using information that has already been collected about a member – specifically their address — and using state of the art analytics solutions, like location intelligence, Anthem is able to connect its members with the highest performing providers. As we continue to focus on growing our business, we must improve our ability to innovate, think outside-in to stay ahead of trends, and leverage the power of technology to transform healthcare and create a better healthcare experience for all Americans.
“While address data might seem like an easy data source to work with, you’d be surprised at how frequently address data can be become riddled with errors,” said Yerubandi. In order to be useful geospatial data needs to be of the highest quality, so it can be standardized and geocoded and used across the enterprise.
“It’s not just being able to manage data that helps us meet our objectives as a business and our commitments to our members, it’s the ability to perform analysis and apply that insight quickly that makes the difference,” he shared.
To this end, Yerubandi is currently exploring geospatial solutions with the team at Pitney Bowes that can be used across enterprise to standardize the quality of our address data managed in various domains, leverage routing intelligence capabilities, and map visualizations techniques within our applications. Yerubandi sees three primary use cases for these solutions to help Anthem take care of their members by ensuring they receive care from the best providers.
“We are exploring geospatial technology from Pitney Bowes to optimize our physician networks and enhance member user experience,” share Yerubandi. The Pitney Bowes Spectrum™ Location Intelligence for Big Data is a toolkit for processing enterprise data for large scale spatial analysis by assigning locations to hexagons and aggregating the data in the hexagons for further analysis. Billions of records can be processed in parallel, using MapReduce, Hive and Apache Spark’s cluster processing framework, yielding results faster than ever. Unlike traditional processing techniques that used to take weeks to process the data, now the data processing can be done in a few hours using this product.
“The most obvious application, as we’ve touched on, is real-time address standardization and geocoding for both member and provider information,” he said. From there, the other applications – routing intelligence for web and mobile to calculate, for example distances between provider and patient and the visualization of this data on interactive maps where the patient can filter data to identify the provider that best suits their needs – becomes possible and all in real time.
But being able to connect members to high quality providers is not the only way in which Anthem is putting data to work to deliver better outcomes by doing trend analysis, modeling, and predictive analytics. The use of machine learning and smart analytic algorithms is helping the organization detect and prevent fraud, waste, and abuse. “Fraud, waste, and abuse are one of the key reasons that healthcare costs continue to rise so rapidly,” said Yerubandi. “Moreover, prescription fraud and abuse has played a primary role in fueling the opioid crisis that’s tearing communities apart.”
Since Yerubandi’s team deals with extremely large data sets, performance is key for their analytic implementations in terms of data ingestion, analytic operations, and exposure of data through dashboards, reports, services, and batch integrations. With a robust analytics & insights platform in place, Anthem is able to take many streams of raw data, analyze them and deliver actionable insights. Business leaders can then act quickly to continue to prioritize the organization’s goals, whether that’s providing the best care to members, empowering them with access to health data via portals and apps, enriching care networks with value-driven providers, or eradicating fraudulent activities.
With this kind of data-driven innovation Anthem is leading the way for health insurers in tackling some of the field’s most pressing issues. In doing so, it’s well on its way to become one of the country’s most trusted and valued healthcare partners and transforming healthcare with trusted and patient-centered solutions. If others in the industry follow suit, we’ll quickly be left with nothing to complain about except, perhaps, the weather.
Ready to learn more about data-driven innovation for health insurance? You can do that here.