Data Analytics

Getting the Most from Real-Time Financial Analytics in Healthcare

Actian Corporation

July 13, 2023

healthcare data security and healthcare financial analytics

Many organizations are implementing real-time analytics that makes data readily available to users and processes as soon as the data is available in the database. This type of analytics lets you make instantaneous decisions based on the most current data. In industries such as healthcare when seconds matter, real-time data analytics gives you the ability to execute ultra-fast queries to inform decisions in the moment.

Real-time financial analytics is one important type of analysis that can deliver results in healthcare. The analytics capabilities support data-driven outcomes across the healthcare organization, from delivering high-quality patient care to mitigating fraud to aligning processes with compliance requirements.

Improve Patient Care While Lowering Costs

Healthcare organizations, from large hospitals to healthcare provider networks, are challenged to provide the best care, improve outcomes, and lower costs. The industry shift from a fee-for-service model to value-based care emphasizes helping patients improve their overall health and live healthier lives.

Applying real-time financial analytics, along with analytics across patient and healthcare data, gives healthcare providers access to the latest information to make the most informed decisions for patient care. Quickly responding to patient needs and setting them on the path to care as quickly as possible not only improves outcomes but also leads to greater patient satisfaction. Plus, the ability to diagnose patients quickly and early in their patient journey can lower costs by avoiding unnecessary tests and treatments.

In addition, real-time financial analytics allows you to better allocate healthcare resources, including staffing, where they’re needed based on usage patterns. Having medical equipment and personnel readily available enhances the quality of patient care.

Similarly, real-time insights into finances and operations can identify areas where you can streamline operations to reduce costs, cut wasteful spending, and improve efficiency. Healthcare administrators can also use real-time financial analytics to create accurate budgets and forecasts using the very latest financial information. Accurate forecasts help you reach your financial and performance goals, ensuring your organization maintains its financial health.

Identify Healthcare Fraud Faster

Fraud is an ongoing problem in healthcare, with the Coalition Against Insurance Fraud putting the cost of fraud as high as $300 billion per year. Early detection of fraud is critical as recovering fraudulent payments is extremely difficult—if the money is recovered at all.

Real-time financial analytics can detect patterns and anomalies in data to quickly detect possible fraudulent activities in healthcare billing and insurance claims. Analytics can identify emerging fraudulent trends that otherwise may have gone unnoticed. Identifying potential fraud in real time lets you take immediate action to protect your organization.

By analyzing billing, claims, and other relevant data, you can also predict when and where medical fraud is likely to occur in the future. In addition, real-time financial analytics can identify insurance claims that are missing information, coded incorrectly, have unusual billing patterns, or show other unusual patterns that could indicate fraud.

On the flip side, analytics can also help process legitimate claims faster. This leads to higher customer satisfaction and shorter lifecycles for claims.

Meet Regulatory Compliance Mandates

Healthcare regulations are often complex and can have different requirements on the state and federal levels. Maintaining compliance is essential. Real-time financial analytics helps ensure you’re meeting regulatory requirements by spotting any deviations from established compliance protocols so you can take immediate action.

Automating the process of integrating and analyzing the large volumes of healthcare data that are available to your organization can accelerate reporting and help identify issues sooner. Automation also reduces the chance for human error.

Applying analytics to internal processes helps you monitor and audit your adherence to compliance mandates. You can ensure your processes meet requirements or identify areas where issues occur. As regulations change, performing analytics enables you to meet the latest mandates and even proactively determine where you could be at risk once new requirements are implemented. Real-time monitoring notifies you of compliance issues as they arise, preventing non-compliance issues from continuing.

Using clinical, financial, and other data can also help you better understand and track hospital readmission rates and patient satisfaction scores. Patient satisfaction is increasingly important and commonly used, along with other criteria, to measure quality of care.

A Data Platform for Real-Time Analytics

The Actian Data Platform has the ability to bring together the massive volumes of healthcare data needed for real-time insights you can trust. For example, the platform enables real-time financial analytics to monitor your financial metrics and effectively track your financial performance. You can determine the profitability of individual healthcare departments and measure the success of new initiatives.

Our platform and capabilities support healthcare providers, payers, pharmaceutical organizations, and others involved in the healthcare industry by enabling them to improve outcomes faster. With easy-to-use, trustworthy data, your organization can accelerate healthcare research, transform service delivery and payments, and optimize an outcome-centric model for care.

Watch a short video to see how we can help with healthcare billing fraud detection. Our platform and capabilities support healthcare providers, payers, pharmaceutical organizations, and others involved in the healthcare industry by enabling them to improve outcomes faster.

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About Actian Corporation

Actian makes data easy. We deliver cloud, hybrid, and on-premises data solutions that simplify how people connect, manage, and analyze data. We transform business by enabling customers to make confident, data-driven decisions that accelerate their organization’s growth. Our data platform integrates seamlessly, performs reliably, and delivers at industry-leading speeds.