4 days ago
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- Business Journals
From bytes to insights and beyond: How data helps power health care innovation
Increasingly, payers and employers are leveraging the latest trends in data analytics and cutting-edge technologies to help better address challenges in health care. In fact, 67% of employers said they already have a strategy in place to collect, store and analyze data that can lead to meaningful improvements in employee health and well-being.
In the past, an imperfect and often complicated health care system, along with rising costs, impacted consumers' ability to easily access care. Nearly 11% of U.S. adults avoided health care due to costs in the previous year, in fact, according to a new report from America's Health Rankings.
The use of data and analytics in health benefits has expanded in recent years from helping provide actionable insights to powering the development of innovative products and capabilities that create simpler, more personalized health care experiences.
'We made over 400 enhancements to our digital experience last year and plan to deliver a similar number through 2025,' said Amy Jordan, vice president of product with UnitedHealthcare's commercial business. 'UnitedHealthcare's newest innovation, our Smart Choice provider search capability, empowers members to more easily find and connect with quality network providers from the palm of their hand.'
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Available to eligible UnitedHealthcare commercial members in the member app and website, Smart Choice provides results that meet member preferences and maximize member benefits, which may result in easier access and lower costs.
When members use the UnitedHealthcare app or to search for providers, they will see Smart Choice results based on multiple factors, including a member's personal preferences and health plan benefits as well as nationally recognized standards* for safe and effective quality care, according to Jordan.
'This is just one way we are putting data and innovation to work as part of a broader goal aimed at reducing heath care expenditures, improving outcomes and creating better member experiences,' Jordan said.
A data revolution: From PDFs to artificial intelligence
In recent years, the ability to access, analyze and use data to shape the future of health care innovations and insights has changed significantly.
'My first couple weeks on the job, I was literally taking printed PDF reports and typing numbers into Excel files to bring the story of data to life. That was two decades ago,' says Craig Kurtzweil, chief data and analytics officer for UnitedHealthcare's commercial business. 'Back then, it was a challenge to even access the data, let alone to translate it and visualize it in a way that an employer could understand.'
Data is now foundational to the health care industry and a cornerstone of its innovation:
Members are using data-driven tools like UnitedHealthcare's Smart Choice capability to more easily connect with quality network providers and make more informed care decisions
Employers are using population data to build employee engagement strategies to help better address certain health needs for specific groups of employees
Physicians and other health care professionals are using nearly real-time data to help improve the care delivery experience with members
'In the past, you had data, but it could take months to get your hands on it.' Kurtzweil says. 'Now there is a flood of data — insightful and valuable data — but it's become increasingly apparent that responsible AI and ML strategies can help translate that ocean of data into actionable insights.'
Turning insight into action for employers and employees
When Kurtzweil and his team meet with employer groups about their health plan performance today, the conversation goes well beyond volume-based discussions and top-line results.
Kurtzweil and team once informed a particular employer with an over 77,000-member population that 42% of their employees had complex conditions, including cancer. As a result of this analysis, the employer deployed a cancer-specific care management team to better support those members, resulting in over $267,000 in savings to those employees by closing 105 gaps in care. [1].
'We can now collect that data, integrate that data and apply those responsible and fair algorithms and machine learning to it in order to uncover trends within employer populations and gain actionable insights for them,' Kurtzweil says.
AI and ML: balancing innovation with responsibility
As more data is captured via overall engagement with the health system, artificial intelligence and machine learning can help sort that data.
In fact, the global health care AI market is predicted to reach $614 billion by 2034, up from $27 billion in 2024, and 92% of surveyed employers said they believe that artificial intelligence (AI) holds promise in health care.
These technologies assist in innovation at UnitedHealth Group — within Optum and UnitedHealthcare — helping make sense of 2 trillion health transactions annually. [2]
While safety, privacy, transparency and responsible use are at the forefront of using AI and ML, timeliness, simplicity and efficiency are also key drivers. Yet no matter how fast or efficient the data is captured, reliable human analysis remains critical and necessary.
'While AI and ML may be important tools in health care as we move forward, developing and implementing it responsibly — and ensuring that the privacy and security of member health data is protected — is essential,' Kurtzweil said.
Footnotes
[1] UnitedHealthcare National Accounts ASO client 2022–2024 analysis, Health Plan Performance Review Oct. 2024. This case study is true. Savings calculated on book-of-business case rate savings for these programs. Savings for enrolled members are case specific. Results will vary based on client-specific demographics and plan design. Results will vary depending on the state where the insured policy is issued and the amount of engagement by employees.
[2] UnitedHealth Group internal data collection and reporting, 2024.
Disclaimers
* Standards utilized by UnitedHealth Premium®. UnitedHealth Premium® is proprietary to UnitedHealthcare. UnitedHealth Premium evaluates physicians based on safe, timely, effective and efficient quality care criteria to help members make more informed choices for their health care. It's intended only as a guide and should not be the sole factor considered when selecting a physician. Designations have a risk of error and members should discuss designations with a physician before choosing one. If a member already has a physician, they should also consult with them for advice on selecting other physicians. The fact that a physician does not have a Premium Care Physician designation does not mean that the physician does not provide quality health care services. All physicians in the UnitedHealthcare network have met certain minimum credentialing requirements (separate from the UnitedHealth Premium criteria). Please visit the medical care directory specific to the member's benefit plan for physician designations and detailed information about UnitedHealth Premium and the evaluation methodology.
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