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CEO Perspective: Leveraging Commercial Claims to Improve Sales

September 11, 2018 BY Alanna Moriarty

CEO Perspective: Leveraging Commercial Claims to Improve Sales

Definitive Healthcare is thrilled to announce the launch of commercial claims data into its industry-leading product suite. Now, in addition to claims data from Medicare, clients will have access to diagnosis and procedure data from a variety of private insurers and managed care plans. For Definitive Healthcare, this new set of real world evidence is just one more step toward becoming the single source of truth for healthcare industry intelligence.

Definitive Healthcare CEO Jason Krantz answered a few questions and shed some light on the launch of commercial medical claims and the value of this data for the healthcare industry.

Jason Rectangle Headshot w Namecard

Definitive Healthcare recently launched commercial medical claims into its database of leading account-driven intelligence on healthcare providers. Can you explain what you mean by "commercial medical claims"?

The team here at Definitive Healthcare takes pride in offering the most updated and comprehensive data on the healthcare provider market. We already had a solid base of patient claims data and analytics in our product from CMS [the Centers for Medicare and Medicaid Services], which includes diagnosis and procedure data for patients insured through Medicare. "Commercial medical claims" refers to insurers outside government-sponsored payors like Medicare. This data is also referred to as "all-payor" claims, which includes both private insurers and managed care plans.

We have integrated more than 3 billion claims for approximately 210 million patients into our existing product suite, covering about 65 percent of the U.S. population. With this newest addition to our database, we have truly revolutionized the industry standard by organizing medical claims from a wide variety of insurers -- far beyond the scope of data we'd previously received from CMS. Our information on diagnoses and procedures is now even more accurate and comprehensive than before and supports our edge as the leading analytic provider.

What is included with the newest product update, and where can users find commercial claims data? 

The good news is that all clients will benefit from this launch. Clients will now have access to updated information on physician practice behavior and as well as payer mix intelligence – key metrics that influence the way many companies engage with healthcare providers, from physicians to hospitals.

Beyond that, Definitive is introducing more detailed views and analytics within individual provider profiles that describe detailed billing patterns and referral relationships by diagnosis or procedure code. The integration of this dataset into healthcare organization and healthcare provider profiles is just one aspect of this update – the other product development work was focused around creating easy-to-use search pages where users can analyze diagnosis and procedure codes across virtually all providers and export that data with just a few clicks.

How is Definitive Healthcare's commercial medical claims data different than that offered by other providers?

Definitive Healthcare has presented commercial medical claims data like no other provider has been able to before. We've organized this enormous dataset into an easy-to-use and searchable product and will be refreshing it on a monthly basis. Our goal is to give clients instant access to the most current claims analytics on the physician, facility, IDN, or market level.

Additionally, we are excited to integrate the dataset with all the other proprietary intelligence we track, putting this complex data in context of key account level intelligence. Our existing platform puts affiliations, financial metrics, quality performance data, and other insights next to the critical, real-world clinical data our clients need.

Why is this data meaningful to your clients?

Many of the customers we serve benefit from our singular focus which is to deliver the most comprehensive data. By combining billions of commercial claims with our existing proprietary data, we are empowering our clients to better analyze market trends, develop comprehensive segmentation strategies, identify industry leaders, and much more. This new integration has the power to revolutionize client sales and marketing strategies.

In our product development efforts, we draw on use cases and workflows from our nearly 2,000 clients to ensure we are analyzing and presenting healthcare industry data in the ways that are most useful to all our end users. The addition of commercial claims is a significant increase in our product coverage and gives a real competitive advantage to our clients. We are confident that this data will revolutionize the industry and become the single source of truth in healthcare analytics.

Watch the short video below to hear more about the commercial claims integration directly from CEO Jason Krantz.


Interested in learning more about how Commercial Claims can benefit your business? Sign up for a free trial today!