Interview Synopsis

Healthcare analytics platforms – Inovalon, Optum & Cotiviti – innovation trends & consolidation outlook

  • Private Equity
  • Healthcare
  • North America

Several forces are drumming up momentum for healthcare analytics platforms, including the shift to value-based care, ageing populations and broader technology developments. Third Bridge Forum interviewed a former SVP at Optum Inc to discuss industry trends, the competitive landscape and changing market dynamics.

Push to predictive analytics the “next frontier” in healthcare analytics

The expert explained what’s driving the shift from descriptive to predictive analytics, which essentially means taking a more forward-looking approach to resource allocation rather than basing future needs on previous indicators. This all feeds into the burgeoning theme of risk forecasting, centred on identifying patients that are most likely to increase the cost of care.

Another major trend, particularly for large, complex organisations, is data centralisation. “For example, if you’re a primary care provider in a large, complex network, having all of the patient data from your patients’ other interactions, with all the specialists they see, is extremely helpful in terms of providing high-quality care,” the expert said.

Delving deeper into the shift towards a value-based healthcare, we were told that this approach is a “totally different ballgame”. Indeed, for those organisations that are transitioning from fee-for-service, data analytics needs go from “being almost nil to being very significant”. Although value-based care in general can be highly profitable, it’s also very challenging, and the transition can be volatile. 

How telemedicine is affecting the industry was also discussed. “Long story short, I think, over the next five or seven years, we will see a large impact, a new frontier if you will, on analytics from this digital health transition,” the expert said.

Thinking about the growth runway in payer, provider or pharma markets, one potential trend on the horizon involves payers and providers “blending together” to enable a “comprehensive view of the patient” and “provide the most seamless experience”. 

Regarding the larger players – Inovalon, Cotiviti or Optum-Change Healthcare – the Interview suggested that because they are so complex and diverse, the main opportunity for differentiation is to clarify and simplify their offerings so that buyers are crystal-clear on what advantages they could bring.

The Interview also discussed the challenges of aggregating and integrating patient data, the role of machine learning, industry consolidation, and the threat of tech giants.

To access all the human insights in Third Bridge Forum’s Healthcare analytics platforms – Inovalon, Optum & Cotiviti – innovation trends & consolidation outlook Interview, click here to view the full transcript. 

The information used in compiling this document has been obtained by Third Bridge from experts participating in Forum Interviews. Third Bridge does not warrant the accuracy of the information and has not independently verified it. It should not be regarded as a trade recommendation or form the basis of any investment decision.

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