Healthcare Business Intelligence: What Data’s Right for Your Team?


When it comes to healthcare business intelligence, there’s no 1 perfect source of truth. Ideally, you should mix and match data sources to create the most complete picture of opportunities in your market.

Let’s walk through the top 4 data sources for healthcare business intelligence and what each bring to the table:

Internal Data–See Your Best Service Lines

Start your healthcare business intelligence journey by reviewing your internal data. This will help you better understand the top service lines within your organization, including the right volumes to target based on contribution margin.

Key Questions to Ask:

  • Which practices &/or providers give us the most referrals?
  • Do any employed providers refer patients outside of our network?
  • Which markets have the strongest patient pipeline & what new markets should we target based on patient population, payer mix, etc.?
CMS Data–Know Your Market Share

Next, use state or CMS data to understand your position in the market today, as compared to previous quarters. Notice if there are any trends that can help you understand which providers, payers and/or markets to prioritize for growth.

Key Questions to Ask:

  • What’s our historical growth performance (service line, key markets, procedures, physicians, etc.)?
  • What’s our current market position?
  • Are we positioned to gain or lose market share?
Claims Data–Target Aligned Providers

Now you can use ambulatory claims data to see which providers are performing your targeted procedures—both in and outside of your organization.

This intel can help you target the best aligned providers for your growth campaign. It can also show you top providers who are most likely to align with your organization going forward (based on their referral sources and/or field intelligence).

Key Questions to Ask:

  • Which providers are most active in our market today by specialty, service line &/or procedure?
  • Where are these providers affiliated? Are they exclusive, or do they split their volumes between facilities?
  • What are their attached referral sources based on shared patient connections?

Speaking of shared patient connections, ambulatory claims data is also great for evaluating which referring providers should be targeted for retention, recovery, nurture or growth.

Key Questions to Ask:

  • What data do we have to better understand our market’s network connections? 
  • Are there relationships that will be hard to navigate or change?
  • Need to be nurtured to maintain current volumes?
  • Can be redirected to support growth?
Field Intelligence–Redirect Patient Pipelines

Tapping into and/or redirecting patient pipelines takes time and planning. Field intelligence data can help you create an effective series of supportive actions. Monitoring referral activity over time can also help your team know when to make adjustments as factors change.

Key Questions to Ask:

  • What series of actions can we take to support this strategy?
  • How many actions did we complete?
  • What % of targeted physicians were reached as a result?
Don’t Forget to Measure Your Results

Of course, it takes time to secure new external data. So, your team should regularly monitor internal data, reviewing volumes and revenues across a campaign. This will help you more accurately measure the overall impact, using both current and baseline measurements.

If you’d like even more information on healthcare business intelligence and the data sources we just covered, download our new white paper Going Big with Data.

Date: February 12 2020
Subject: Healthcare Analytics
About the Author
Carrie Bennett
Carrie Bennett

Strategic Advisor
(Former COO)