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.
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.
The downstream effects are costly and far-reaching:
Getting out of this cycle starts with a mindset shift. Data must be managed as a strategic enterprise asset, not a departmental tool.
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:
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.