Claims data for commercialization

Medical claims data is an incredibly valuable asset in the healthcare industry. They reveal critical information about performed procedures, diagnoses, locations of care, and associated costs for specific procedures and diagnoses.

For sales and marketing executives, claims data is part of the healthcare commercial intelligence you can leverage to guide your commercialization decisions and bring your treatment, solution, or services to market efficiently and effectively.

Below, we explore three impactful ways sales and marketing professionals can leverage claims data to optimize their commercial strategies.

1. Find the total addressable market to guide go-to-market strategies

Understanding your total addressable market (TAM) is crucial for any successful commercialization plan.

Medical claims provide data on the number of diagnoses and procedures performed, patient prevalence, and provider activity, offering a clear picture of the market size for your product or service, and enabling your sales and marketing team to expand their go-to-market strategy. Everyone’s TAM is different—and it’s a metric that changes over time—so it’s important you have the most accurate and useful data available when you next need to calculate your TAM.

To put this into practice, suppose you’re introducing a product designed to enhance outcomes in knee replacement surgeries. Claims data helps you:

• Determine market size. By analyzing CPT codes, you discover that 750,000 knee replacements are performed annually in the United States.
• Identify key providers. You find that 20% of these procedures are performed by just 15% of providers, allowing you to focus on the highest-value targets.
• Prioritize regions. Claims data reveals that knee replacement volumes are particularly high in the Midwest, suggesting a regional focus for your launch efforts.
• Refine messaging. By segmenting providers into those with high, medium, and low volumes of knee replacements, you can tailor your outreach to address their specific needs.

Beyond segmenting your market, you can also use claims data to map the relationships between patients, diagnoses, providers, and care settings. This interconnected view enables your teams to understand which providers are performing the most relevant procedures or treating the most patients with specific diagnoses, and where your solution fits into the patient journey.

2. Drive informed sales conversations with healthcare organizations and providers

A major advantage of leveraging claims data is the ability to personalize your sales conversations with concrete, real-world evidence. This approach accomplishes three things: It helps you build trust, position your solution as the more viable investment, and address the specific challenges, wants, needs, and pain points of your audience.

For example, let’s say you are a pharmaceutical company selling a diabetes drug. You can use claims data to assess diabetes prevalence within a given hospital’s patient population. By presenting this analysis to the decision-maker, your sales representative can illustrate how the hospital is tracking against industry benchmarks and explain how the drug can improve patient outcomes or help achieve quality-of-care metrics.

Ultimately, the “one-size-fits-all" approach to messaging is no longer effective and no longer resonates with healthcare organizations. Using claims data gives your marketing and sales teams a data-driven edge that can lead to more meaningful, personalized conversations and potentially more successful deals.

3. Conduct a competitive market analysis

To execute a successful sales or marketing strategy, you need to understand where you stand against your competitors. To do this, you can conduct a competitive market analysis, which can help shed light on your competitors’ strengths and weaknesses, as well as where in the market they are most active—and successful. This kind of intelligence can translate into new opportunities to enter the market or grow, a deeper understanding of your target audience, and a benchmark for success.

So, how do you get started? With claims data!

Medical claims data allow you to dissect the market by examining provider activity, geographic trends, and treatment prevalence. By focusing on specific CPT and ICD-10 codes, you can zero in on the volume of services performed and the providers executing them. This granularity reveals where competitors are dominant and where gaps exist—information you can use to identify your key differentiators and serve the people and organizations most in need of your solutions.

Claims data also serves as a benchmarking tool, enabling you to compare the real-world performance of your product against competitors’. By analyzing usage rates, outcomes, and adherence patterns, you can refine your value proposition to resonate more with your audience.

By leveraging claims data for competitive market analysis, your sales and marketing teams gain a clear understanding of the competitive landscape. This comprehensive view enables you to:

1. Prioritize high-potential accounts.
2. Fine-tune messaging that appeals to providers using competitor solutions.
3. Enter untapped markets with precision.
4. Strengthen relationships with existing customers to secure loyalty.

The result? A sharper, more targeted strategy that empowers your team to outmaneuver competitors and achieve sustainable growth in the healthcare market.

Learn more

Medical claims data is a cornerstone for modern healthcare sales and marketing strategies. By leveraging this data your team can unlock actionable insights to enhance their go-to-market approach.

Ready to take your commercial strategy to the next level? Book a free trial today and discover how claims data can revolutionize your sales and marketing efforts.