A Case Study for Health Plan Leaders: Reframing Women’s Health as a Value Strategy
What Opportunities Are Hiding in Your Claims Data?
Health plans invest billions each year in programs and technologies designed to improve outcomes and reduce costs. But traditional claims analysis was built to process payments, not reveal where innovation can create the greatest value.
The challenge goes beyond how claims data is organized. Some of the information needed to fully understand a patient's journey was never captured on the claim in the first place. Yet even within those limitations, there are significant opportunities hiding in existing data that traditional approaches often overlook.
Women's health is a powerful example. In this workshop, participants will explore how one of the nation's largest managed care organizations reframed existing claims data to transform women's health from an overlooked category into a top-six cost driver and strategic investment priority. We'll also discuss where claims data falls short and why understanding those gaps is essential for making better investment decisions.
The same methodology can be applied across chronic disease, musculoskeletal care, behavioral health, nutrition, and other areas where fragmented or incomplete data can obscure the full clinical and financial opportunity.
Drawing on decades of experience in payer strategy, healthcare economics, commercialization, and market access, Stacey Mennillo Dieterle, MBA, and Demi Radeva, MSc will share a practical framework for interpreting existing data, recognizing its limitations, and turning insights into investment priorities and business cases healthcare leaders can act on.
In this session, you will learn:
Why traditional claims analysis can obscure the true cost and impact of women's health
How one health plan uncovered an invisible cost category and elevated it into a strategic priority
How to translate data insights into a compelling business case, whether you are building one inside a health plan or pitching one as a healthcare innovator
Participants will leave with a practical methodology for identifying overlooked opportunities, understanding the limitations of claims data, and building stronger value propositions that improve both member outcomes and health plan performance.