The Hidden Cost of Data Inefficiency

How often has your plan asked a provider for the same patient information? Or paid for data that already exists somewhere else within your organization?

These aren’t isolated incidents. Redundant data requests, duplicated efforts, and inconsistent member views are symptoms of a larger problem. Health plans don’t lack data; they struggle to use it efficiently and strategically.

Where the Disconnect Happens

Siloes exist in nearly every health plan. Enrollment, care management, utilization management, quality, customer service, and risk adjustment teams all collect and store data for their own purposes. That information rarely flows across the organization in a meaningful way.

For example, social determinants of health data gathered by care management may never reach behavioral health or risk adjustment teams that could benefit from it. The result is a fragmented picture of the member.

In addition, there is the absence of data governance policies, unclear rules around access and sharing, and no shared understanding of acceptable use. In many plans, even finding existing data is a challenge, let alone using it consistently.

Why It Matters to Your Bottom Line and Brand

The downstream effects are costly and far-reaching:

• Operational inefficiency. Staff waste time searching for data or recreating it.
• Provider frustration. Asking for the same information repeatedly damages relationships.
• Member dissatisfaction. Members expect their plan to have a comprehensive view of their care.
• Missed opportunities. Without a complete and trusted data foundation, predictive analytics and proactive engagement strategies fall flat.

Treating Data as a Strategic Asset

Getting out of this cycle starts with a mindset shift. Data must be managed as a strategic enterprise asset, not a departmental tool.

• Develop a cross-functional strategy. Define governance, ownership, workflows, and shared goals.
• Enable smarter access. Provide role-based views and interoperable systems that allow staff to use existing data.
• Train your teams. Technology alone doesn’t solve process problems. Staff need education, context, and tools.

Where POCP Can Help

Objectivity is critical. Internal teams are often too close to the problem, constrained by organizational lore, pet projects, or long-held assumptions that no longer serve the mission.

Point-of-Care Partners (POCP) brings an outside perspective and a structured approach:

• Assess and analyze. We work with and across departments to uncover how data is really being used—and where it isn’t.
• Identify gaps. We document friction points and missed connections between departments, systems, and processes.
• Deliver strategic roadmaps. We build practical, tailored action plans that align people, processes, and technology.
• Support education and change. Through comprehensive education sessions, we help staff connect the dots needed to make improvements and shifts in approaches stick.
• Guide implementation. We serve as trusted advisors through planning, execution, and transition.

It’s Time to Stop Working Around the Problem

Health plans already have the data they need to improve member experience, reduce costs, and engage more effectively. What’s missing is alignment—and sometimes the willingness to challenge internal assumptions.

POCP can help you see the whole picture and make meaningful progress. Contact us to set up a time to talk about your member data diagnostic and governance challenges.