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How to use data to drive operational excellence within medical professional associations

Today’s healthcare landscape is marked by labor shortages, professional burnout, and rapidly shifting care trends, leading providers to seek strength in numbers. In these evolving and uncertain times, medical professional associations serve as a steadying force for their members by providing critical resources and advocacy.

To maximize the impact of their supportive efforts, medical professional associations need to really understand their members: Where and how are they practicing? What challenges are they facing? Who are their patients?

With the right data, medical professional associations can answer all these questions—and develop deeper insights about nonmembers, creating new opportunities for outreach and growth.

In this guide, we’ll examine how to use healthcare commercial intelligence from multiple sources to support your day-to-day operations, from driving positive outcomes for members to marketing more effectively to nonmembers. After reading this guide, you should understand how to use a variety of data sources—including claims and reference data, primary research, and news and intelligence—to make more confident strategic decisions for your association.

Understand your members to serve them better

Even if you routinely survey your members, there’s a good chance that you’re missing some critical information on who they are, where and how they practice, and who they work with. Without this information, it’s difficult to tailor your messaging and services to the specific needs of your membership.

Layering in external data can help you verify your existing membership data and see the bigger picture. By adding claims, reference, and affiliation data to your workflow, you can understand your members’ practice patterns and their relationships with other physicians within the market. This data also makes it easier to see which patients and disease states your members are treating, as well as how those patients are paying for treatment.

Your members may be executives, volunteers, part of an independent physician association, or work part-time at community clinics. Each of these roles faces different challenges—understanding how they’re represented among your membership is crucial for delivering meaningful outreach and resources.

One member may self-report as working at an academic practice, for instance, but simultaneously bill through an associated private practice. If you’re working on creating resources for members in private practices, this member would be left in the lurch—unless you use claims data to verify your members’ industry activities.

You can use procedure claims to determine how many of your members are performing a particular service and in what settings. Paired with affiliations data, claims can reveal whether a physician is practicing according to their title and specialty or taking on work beyond what they’re self-reporting. With an accurate picture of your members’ functional interests, you can help them hone in on high-value opportunities, develop their expertise further through targeted education, or plan event agendas with content that truly matters to them.

Claims data also helps you spot potential issues related to utilization and reimbursement.

For example, is one of your practices struggling with reimbursement for certain types of procedures? You can cross-check claims and reference data to see how patients receiving those procedures are being referred, how the claims are being submitted, and whether your physicians are taking on patients as consultants or direct referrals. These insights can help you decide whether reimbursement is denied due to coding/billing issues, improper referrals, or simply because the patient is a poor candidate for the requested services.

Make sure you’re ready to integrate data

In today’s digital-first work environment, you’re likely already working with some data, whether it’s self-reported member surveys, customer relationship management (CRM) system data, or manually collected contact information on local prospects.

Before you try to integrate new data sources or reimagine your data strategy, assess the data you currently have: What does it tell you about members and nonmembers? Where are your blind spots? How can it inform your engagement strategies?

For instance, you probably have a database of member information, but how frequently is that information updated? If you’re relying on members to provide their own information, it may quickly go stale—or it may be inaccurate from the start.

If you’re already working with some market data, consider what it can tell you and how much of the market it captures. Does it only cover certain zip codes, facility types, or physician activities? What questions does it leave unanswered?

Whether you’re focused on growth or looking to better serve your current members, it helps to use a variety of real-time data sources:

  • Claims data gives you perspective on physician behavior, revealing the diagnoses, procedures, and prescribing activities that drive their practice so you can tailor your messaging and service offerings.
  • Healthcare reference and affiliations data offers detailed intelligence about the relationships and connections between providers and organizations like hospitals, community clinics, and physician groups.
  • Executive and physician contact information makes it easier to identify and reach out to leaders with broad networks who can benefit from your support.
  • Primary research helps you spot key opinion leaders (KOLs) and rising stars making an impact in social networks, academic circles, scientific publications, and conference circuits.

Individually, these sources can only offer a limited view of your membership and your market. But analyzed together, this commercial intelligence can help you determine who your members are and how you can support them—as well as where to look for prospects.

Achieve growth through more effective targeting and outreach

Finding the right members is a top priority for most medical professional associations. If you’re not working with the latest, most complete datasets, you’re missing physicians who could be a great fit for your organization.

You can spend hours conducting firsthand research using publicly available data on medical school graduates and board certifications associated with NPIs, but these data points only offer narrow snapshots of a certain point in a physician’s career (usually no more than its earliest stages). Even if you manually cross-reference this information with physicians’ LinkedIn profiles, you’re looking at an incomplete, potentially misleading portrait of a person who may or may not be suited to membership.

With all-payor claims and reference and affiliations data on medical groups, hospitals, surgery centers, community health clinics, and other facilities, you can track a physician’s entire professional journey and see:

  • Which patients, diagnoses, and procedures they’re most experienced with
  • Which providers they take referrals from—or refer to
  • Whether they shape prescription decisions or stick to refills

This information gives you a solid foundation on which to identify targets and build your messaging. Layer in organizational structure and contact information to more effectively reach your targets or identify decision-makers who can further influence potential members.

Primary research into social networks, scientific publications, and speaking engagements can help you spot KOLs and rising stars whose reach extends far beyond their practice and referral history. While these influential figures can be incredibly valuable members, you’ll need to demonstrate your association’s value to them first.

Luckily, all the data sources outlined here make it simple to underscore your value to nonmembers and members alike. Take insights derived from your data sources and compare them with industry news to develop intelligence related to emerging trends. With an understanding of the market and the most relevant trends, you can show that your association is ready to help identify and address new business opportunities as they arise.

What it all means

Healthcare commercial intelligence built on claims, reference and affiliations data, and primary research can deliver useful insights to medical professional associations looking to better understand and serve their members and achieve growth through new membership. By leveraging this data, you can verify and validate existing membership information, tailor your resources and events to members’ unique needs, and target and engage potential members more effectively.

For more information on developing data-driven operational strategies, check out these resources:


    In today’s digital-first work environment, you’re likely already working with some data, whether it’s self-reported member surveys, customer relationship management (CRM) system data, or manually collected contact information on local prospects. Before you try to integrate new data sources or reimagine your data strategy, assess the data you currently have: What does it tell you about members and nonmembers? Where are your blind spots? How can it inform your engagement strategies?