As we prepare for the new year, the healthcare industry has been propelled forward by remarkable advancements in Generative AI (Gen AI), value-based care (VBC), and the electronic health record (EHR) data integration. While the overall goal of improving patient care has remained on track over the years, the introduction of Gen AI is revolutionizing operational efficiencies and unlocking the potential of diverse data sources in unprecedented ways. In this blog post, we’ll explore how recent trends have impacted healthcare analytics in 2024 and offered organizations new ways to leverage data for better outcomes in 2025.
The rise of Gen AI in healthcare analytics
Throughout 2024, Gen AI took center stage regarding its potential to streamline administrative processes at lightning speed, making it a game-changer at key industry events. Despite the excitement, important questions have arisen about how to effectively implement and scale Gen AI models, as well as how they can deliver on their promise without compromising quality or safety.
At Milliman MedInsight, our payer customers have expressed their interest in using Gen AI to streamline administrative tasks. Their goal is not to replace existing work entirely but to leverage Gen AI as appropriate to dedicate more time to supporting impactful initiatives.
Nearly a third of survey respondents have adopted Gen AI primarily for data cleaning with mixed success rates.1
A recent survey by Milliman MedInsight revealed that nearly a third of respondents have already implemented Gen AI to streamline data cleansing. However, the outcomes of using generative AI for this and other tasks have been inconsistent. While the potential benefits of Gen AI are significant, organizations should focus on its responsible application and ensure the use of secure, trustworthy data. Establishing strong partnerships will be essential for enhancing technological capabilities and staying abreast of the rapid changes in this field.
Digital transformation powers value-based care
A key element of a successful VBC strategy is ensuring data integrity and accessibility. While organizations are considering the adoption of modern technologies, many healthcare systems still rely on outdated applications and core claims management software. This can lead to persistent issues such as data fragmentation, inconsistencies, and inaccuracies, all of which pose significant obstacles to VBC and Gen AI adoption. These problems not only impede the effective assessment and comparison of outcomes but also hinder progress for organizations that are already resource-strained.
To excel in VBC, organizations must undergo a digital transformation to support innovation in value-based payment mechanisms, which heavily depend on complex data, electronic health information, and advanced quality and performance metrics. VBC also necessitates a substantial overhaul of an organization’s financial structure and reimbursement methods, which can be both daunting and financially risky. The first step is to establish the necessary infrastructure and technology capable of managing large volumes of data. By leveraging a unified analytics platform, organizations can foster better collaboration among providers and health plans, promoting shared responsibility and improved healthcare outcomes. Most importantly, such platforms can enhance transparency, enabling efficient data collection, analysis, and sharing across different care settings, thereby helping organizations achieve their VBC goals.
EHR data integration: The key to comprehensive care
The shift towards VBC is becoming increasingly dependent on the successful integration of electronic health records (EHRs) with claims data. When these two data sources are combined, they provide a complete view that leverages the broad overview of billing and insurance information from claims data with the in-depth insights into specific medical events and patients’ health statuses from clinical EHR data.
One of the most significant advantages of integrating EHR data with claims data is enhanced care coordination and care gap closure. When all stakeholders have access to the same, accurate health information, they can make more informed decisions and provide more efficient and effective care. This collaborative approach not only improves communication and coordination but also streamlines workflows, reduces redundancies, and minimizes the risk of medical waste and errors, such as repeated tests or conflicting treatment plans.
Moreover, the integration of EHR and claims data can have a profound impact on healthcare operations. It improves efficiency by centralizing patient information, increasing data accuracy through standardized and consistent records, and enabling a greater focus on patient care rather than administrative tasks. With a more complete understanding of patient care and outcomes, healthcare organizations can gain the extensive insights needed to advance their VBC initiatives, ultimately leading to better health outcomes and a more sustainable future.
Join our webinar: Reflecting on 2024 and predicting the future of trends
As we look to the future, the significance of healthcare analytics is undeniable. The ability to tap into diverse data sources, process unstructured data, and integrate various data types to uncover valuable insights will continue to be a key differentiator for healthcare organizations. By adopting the latest technological innovations, these organizations can more effectively address their changing needs and help build a more efficient and effective healthcare system.
To stay ahead of the curve, don’t miss out on our upcoming webinar where we will discuss these insights in detail. Save your spot at our “Analytics in action: Reflecting on 2024 and predicting 2025 trends” webinar December 17th | 11:00am – 12:00pm PT.
1 Milliman MedInsight Payer Survey data