Analytics in Healthcare and the Life Sciences: Strategies, Implementation Methods, and Best Practices

23. Aetna

Kyle Cheek

Healthcare payer organizations are undergoing a fundamental change to their traditional business model. Largely in response to cost pressures, payers are evolving from their traditional role as transaction-focused claims processing organizations to producers of analytically derived, information-centric consumer products. Payers have a long tradition of reliance on analytics tracing to their actuarial roots, but the recent transformation transcends the use of actuarial analytics to set rates and reserves. Rather, the move toward greater exploitation of value-laden information is centered on a deeper understanding of healthcare consumer behavior with the intent to influence behaviors and ultimately drive meaningful reductions ...