Catalyst for Payment Reform

Finding value with CPR’s Data Warehouse & Analytics Evaluation project

Finding value with CPR’s Data Warehouse & Analytics Evaluation project

Data warehouse and analytics vendors are important partners for the employers and other health care purchasers who self-fund health care coverage for their employees and their dependents. A data warehouse amalgamates and securely stores a wide range of data so that the benefit managers and consultants at the helm of employer-sponsored health care programs have an independent means to analyze the millions or billions of health care dollars spent each year. These types of data typically include medical, pharmacy, dental and vision insurance claims, disability claims, information about employee eligibility for various insurance and other programs, participation in wellness programs, absenteeism and more.  Data warehouse and analytics vendors often develop products that integrate and transform various data feeds into dynamic dashboards and analytic reports that help benefit managers and their consultant partners make smarter strategic decisions.

CPR has consistently heard from employer-purchasers that a lack of actionable data is a barrier to adopting high-value strategies. We decided to look into this vital question, asking, “are data warehouse vendors delivering the quality product that progressive employers need to purchase high-value health care?” So, just like CPR did for vendors in the mental health space, our staff embarked on an evaluation of the strengths, weaknesses and opportunities for growth of vendors in the data warehouse and analytics marketplace.

To prepare a framework for the evaluation, CPR staff conducted research by speaking with experienced and diverse employer-purchasers as well as interviewing subject matter experts. CPR wanted to understand what purchasers see as best practice from data warehouse vendors. We convened an advisory committee of CPR members for the initial review of the evaluation criteria and then invited other members to provide feedback.  The criteria cover the following areas:

  1. Data Management and Security
  2. User Experience & Support
  3. Reporting & Visualization
  4. Specific Analytics, focusing on value

A commentary we published in Employee Benefits News shares a closer look at purchaser expectations in each area.

After finalizing the criteria, we invited vendors that provide data warehouse and analytic software and services to public and private health care purchasers to participate in the evaluation. CPR sent a request for information (RFI) to leading vendors; seven vendors opted to participate. CPR then used the purchaser-defined specifications to evaluate their offerings.

Upon evaluating key vendors in the market, we released the evaluation framework, RFI questions, and specifications as a toolkit. Our belief is that coordinated demands from purchasers can more effectively push the health care marketplace place in the right direction, so we hope that numerous purchasers log into their account to take advantage of this resource for free. We also published a public report on where the data warehouse marketplace stands and how well it is poised to meet the needs of tomorrow’s health care purchasing challenges. While CPR did not charge vendors to participate in the evaluation process, we gave them the option to contribute financially in exchange for receiving in-depth feedback on how their product performs against CPR’s purchaser-defined evaluation criteria as well as some marketing opportunities through which we will introduce you to the vendors who participated in the evaluation process.

And the ratings of these seven vendors? Like the mental health evaluation we conducted last year, we produced summary scorecards as a benefit for our members. We intend to continue to evaluate vendor solutions in order to assist our members in selecting their future health care partners– our next area of evaluation is for vendors that arrange for the payment of episodes of care through bundled payments.

It’s complicated as a health care purchaser to find higher value health care. We hope that these resources spur vendors to better meet the needs of purchasers. It’s our belief that empowered customers + engaged vendors = a marketplace that benefits everyone.

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