Before Jason Cooper joined Horizon Blue Cross Blue Shield of New Jersey as Chief Analytics Officer in February 2015, analytics for the state’s largest and oldest health insurer was decentralized, sometimes duplicative, and while quite effective, not always optimally efficient.
The company’s analytics-oriented technology infrastructure and human capital investments had fallen a bit behind the times. “We weren’t deriving as much tactical and strategic value from analytics as we should have been,” said Cooper, who will be sharing best practices for achieving peak results with data analytics at the 2017 New Jersey CIO Executive Leadership Summit in Iselin, NJ on May 4th.
Under Cooper’s leadership, Horizon BCBS of New Jersey centralized analytics and kicked off a rigorous demand management assessment within its IT, Strategy, and Business Process Improvement (BPI) divisions. That assessment led Cooper and his 100-plus person team to formally launch an analytics transformation project and identify four areas for investment: organizational change management, from how the analytics team was structured, stakeholder management, and workforce planning; analytics infrastructure; self-service analytics via data visualization tools for senior executives and other contributors; and the automation of manual processes and rationalizing low-value work that could be eliminated.
Self-service data visualization tools are now enabling senior executives and other leaders to track the performance of the patient-centered medical home (PCMH) and accountable care organization (ACO) as well as monitoring key performance indicators (KPIs) for divisional units and across the enterprise.
One example of the top benefits realized through the use of the self-service visualization tools has been for root cause analyses behind first-call resolution rates for customer service associates with members. “This will eventually help us to better understand which customer service associates are knocking it out of the park (in terms of exceeding member needs) and to identify opportunities for additional training or support that may be needed by other associates,” said Cooper.
The success of the company’s self-service initiative is hardly surprising to industry experts. According to a 2016 study conducted by Forbes Insights, the most successful business intelligence programs are significantly more likely to place analysis and decision-making tools in the hands of business users.
Upskilling and reskilling the analytics team
Cooper has also worked to strengthen the technical skill sets of his 100-plus person analytics team who already possessed deep business acumen before he came onboard. Targeted training has included SAS, Tableau, R, Python, Hadoop, Spark, and Aster, an advanced analytics platform from Teradata. Team members have also been coached in data visualization and consultative techniques. Cooper has also instituted analyst and leadership user groups that meet to discuss hot topics and knowledge sharing. Cooper has also added a data science team to complement the company’s advanced analytics capabilities.
One of the top initiatives that Cooper and his team have been focused on is the company’s value-based transformation – moving the state of healthcare in New Jersey from fee-for-service to a fee-for-value model. As part of these efforts, Horizon BCBS of New Jersey participates in the Omnia Health Alliance, a partnership model with many of the leading delivery systems throughout the Garden State including Atlantic Health System, RWJBarnabas Health, Hackensack Meridian Health, Hunterdon Health, Atlantic Regional Medical Center, Inspira Health Network and Summit Medical Group.
“In order to succeed in this attainable but challenging goal, we have to provide insights and decision support tools to both our internal decision makers as well as our healthcare system partners,” said Cooper.
Beyond supporting the alliance’s triple aim – improving quality, reducing cost and improving experience -- analytics is also being used proactively in the development of predictive and prescriptive models to improve healthcare. For instance, Cooper’s team utilizes LANE (Low Acuity, Non-Emergency) algorithms to showcase events where individuals have sought care in the emergency room for clinical episodes that could be cared for in urgent care or primary care facilities.
“Large integrated healthcare organizations are starting to see where they can divert people with ear infections or other medical conditions that can be treated at urgent care facilities,” said Cooper. Although Cooper’s team is still in the early stages of quantifying the outcomes for these approaches, the use of the LANE algorithms has shown promise in providing patients with more efficient care more cost effectively while potentially reducing patient volumes and wait times in hospital emergency rooms.
Meanwhile, the development of opioid addiction models to better understand the statewide opioid epidemic have begun to help Horizon BCBS to target those areas in greatest need of assistance, such as helping to identify the most efficient use of resources.
Through its decision-support initiatives as well as the distribution of self-service data visualization tools to senior executives and other stakeholders, Cooper and his teams have provided business leaders the ability to make real and near-real-time, informed decisions based on solid data and insights. Meanwhile, the same insights-driven business decisions – enabled by analytics – are playing out daily in several divisions across the enterprise.
Teamwork has been a key contributor to success, said Cooper. “The progress we’ve made in the two years I’ve been here wouldn’t have been achieved without a high level of collaboration between our CIO, CTO, and organizational leaders,” said Cooper.
To gather additional insights from Cooper and other thought leaders who will be presenting at the 2017 New Jersey CIO Executive Leadership Summit, click here.