Member Insights with Healthcare Analytics Solutions™

Robust lab data and analytics can set your plan apart by helping you identify services faster to reduce overall member costs

When it comes to your members’ health, quality shouldn’t be a trade-off, service shouldn’t be a sacrifice, and cost shouldn’t be a barrier. Quest Diagnostics is powering the promise of affordable care and better outcomes through smarter, faster member insights.

Get ahead of risk and transform the way you care for members

Member Insights with Healthcare Analytics Solutions from Quest Diagnostics combines rich laboratory data and predictive analytics to help you proactively identify health risks and inequities for new and current members, so you can act earlier when outreach and intervention often have the most impact.

Our innovative and flexible Member Insights with Healthcare Analytics Solutions can help you:

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    UNDERSTAND disease history and future risk through test results and predictive analytics

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    DECREASE THE COST of care by identifying at-risk members sooner

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    ENGAGE MEMBERS in their care and provide the right interventions at the right time

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    FILL IN GAPS in care for new and existing members to improve population health

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    IDENTIFY specific program eligibility for new and existing members to inform care coordination strategies

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    DELIVER OVERALL BETTER EXPERIENCES by understanding your members’ health status and supporting them sooner, leading to higher Consumer Assessment of Healthcare Providers and Systems® (CAHPS) scores

Redefining member experiences starts with better information

Our plans provide:

  • Longitudinal patient data including up to 2 years of new member historical lab results that predates membership to your plan

  • Predictive member cost score that helps your teams support the right interventions, for the right patients, at the right time
  • Member lab data from indirect care sources (inpatient, retail locations, etc) for a more complete picture
  • Predictive patient-based inferred disease list that can help identify needed services earlier—critical in Chronic Kidney Disease (CKD), high-risk pregnancies, diabetes, and cancer
  • Highly specific prediction for CKD to provide timely interventions that can help prevent acute exacerbations and costly care
  • Access to comprehensive data and customized reporting when you need it
  • An intuitive, searchable portal to give your team the information they need to intervene earlier



Some regional plans are challenged with member-level insight, learning about health status up to 60 days after members join.1

Member Insights with Healthcare Analytics Solutions helps you understand members’ health status sooner to:

  • • Optimize lab spend
  • • Establish a baseline for member health
  • • Mitigate risk
  • • Manage cost
  • • Individualize care delivery
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According to the US Renal Data System, the total medical cost for CKD in 2013 was $50.4 billion among fee-for-service Medicare patients.2

Predictive insights can
help with prioritization



of plans prioritize members that need the most care, helping to drive efficiency1

Our extensive lab data can help your plan managers:

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    ACT EARLIER to support and inform care coordination strategies and specific program eligibility for new members

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    ASSESS MEMBER RISK prior to receiving the first claim

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    PROMOTE APPROPRIATE, guideline-based testing

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    SUPPORT RISK ADJUSTMENT to inform coding and disease management once a member visits his or her doctor

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    PRIORITIZE HRA SPEND on the qualified healthcare expenses that will have the biggest impact on members

As a diagnostics leader with access to billions of lab data points and groundbreaking analytics, Quest is committed to bringing you closer to a 5-star rating.

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1. Data on file. Quest Diagnostics; 2021.
2. Golestaneh L, Alvarez PJ, Reaven NL, et al. All-cause costs increase exponentially with increased Chronic Kidney Disease stage. Am J Manag Care. 2017;23(10- Suppl):S163-S172.