How to Break Down the “Claims” on Claims

In today's health care landscape, data has become the currency that drives informed decision-making. You can’t go a day without hearing bold statements from companies promising revolutionary data that will drive "unprecedented precision" and "transformative intelligence.”

At Sg2, a Vizient company, we sift through these glossy guarantees so that you can understand the gap between what's promised and what's delivered. Here's what to watch for.

Claim #1: "We have the largest, most accurate data set!”

Ultimately there is a finite number of claims data sources, and no provider has 100% activity. Even if it were possible, not all data would necessarily be relevant to your market. That doesn’t mean you can’t discern meaningful insights that drive strategy, as strategy comes from data plus translation.

For those who pledge they have 100% of the market data via modeled data, it’s time to probe further. Cyber-attacks and increasing restrictions in this changing industry have limited sources and forced providers to rely more on modeled data, and those models might not be accurate. Ask them to quantify exactly how these attacks affected their data quality.

Claim #2: “We have the most up-to-date data!”

Despite promises of "real-time" analytics, claims data typically lags by months. Even monthly feeds have required lags. Unless they’re the payor, no platform has early access to real-time data, updates, or VIP standing. You should be able to know when their data was last refreshed and subsequent impact on the information you receive.

Claim #3: "You don’t have to lift a finger!”

Some platforms promise to do it all: source, clean, organize, analyze, and deliver instant insights through sleek dashboards and AI-models. But healthcare data remains extraordinarily complex and data alone is limited: it shows the what but without clinical detail or patient context, it misses the why.

What goes unmentioned is the significant investment of time, expertise, and resources still required from your team to realize even a fraction of that promised value. Platforms alone don't create organizational change—your people do, and they need more than just another dashboard to do it.

The most successful partners don’t offer just data platforms—they will also bring in human experts to expand data literacy and analytical capacity across teams, paired with clear strategies for how data will drive specific decisions.

Claim #4: “We take data security seriously!”

Last year’s data security breach affecting claims data across the industry was a wake-up call, but did it result in real change? In the aftermath, many vendors rushed to adopt certifications meant to signal strong security and privacy standards. However, too often, these declarations lack transparency. Few providers share the actual safeguards they’ve implemented or how they respond to breaches and security threats.

When evaluating partners, ask not just what they promise but how they deliver, and whether they have a proven track record. Many newer entrants tout rapid transformation but haven’t yet demonstrated staying power. Before you commit, consider: will they be there when it matters most?

So where does that leave you?

Any platform promising dazzling demos and pledges of instant transformation is bound to disappoint when users realize technology is a single component of strategic change.

At Sg2 we don’t expect our members to make sense of complex claims data alone. Our best-in-class service model is built into the offering to help you translate data into action, aligning insights with your goals and supporting the change management required to drive real outcomes.

And we’ve been doing it for decades—something no other platform can say.

The years spent developing claims tools and building trusted relationships with strategy, planning, business development, and service line leaders has given us a unique ability to help members not just interpret the data but act on it with confidence. The numbers say it all: in 2024, our partnered relationship approach yielded a 99% retention rate.

The path to better insights at your organization doesn't run through a platform alone. It runs through thoughtful leaders like you who understand that technology is just one component of meaningful change.

Sg2 is not just a vendor: we strive to be a comprehensive, strategic partner focused on your long-term quality and growth. We don’t make flashy promises. Instead, we’re transparent about what we can do, we guide you towards actionable insights for strategic decision making, and we’re committed to walking the path with you.

For more information on evaluating vendors in the claims data space, check out our 10 Most Important Criteria When Choosing a Claims Data Vendor checklist, including key questions to ask.

For more on Sg2 claims data, revisit last month's blog, Data for Decisions: A Platform Perspective for Executive Leaders.