Industries / Health Insurance

SAS® for Health Insurance

Improve operational efficiency and increase bottom-line results

Health insurers are under increased pressure to improve the way they do business. But inefficient business processes, lengthy claims processing and outdated information management strategies are proving to be formidable roadblocks to demonstrating value to those who purchase health care benefits. To overcome the roadblocks, health insurers must shift from a reactive to a proactive stance by predicting – and responding to – challenges before they occur.

" "The current climate requires us to fundamentally change the way we do business; analytics are a required ingredient in our transformation. It's one thing to have information at your fingertips. It's another to use that information effectively. SAS Analytics make that difference.""

— Avery Earwood

Director of Best Practices Solutions
Independent Health

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Which Problem Are You Trying to Solve? 

Fraud Detection and Prevention

Go beyond traditional, rules-based fraud detection to make predictive, accurate claims decisions before claims are paid.

Health and Condition Management

Predict risk and optimize interventions in order to achieve improved outcomes.

Actuarial Analysis

Understand trend drivers, predict financial performance with greater accuracy and empower your reserving strategy.

Customer Insight

Respond to changing demographics and consumer demands.

Health Insurance Solutions

The SAS® Fraud Framework for Health Care

Outright fraud costs the health care industry an estimated $70 billion each year. Only 10 percent of such fraud is ever detected, and only 10 cents of each fraudulent dollar billed is ever recovered. Health insurers pass these losses on to consumers in the form of higher premiums. In the case of self-funded plans, losses result in dollars intended for plan benefits never actually being available. That's why SAS developed the SAS Fraud Framework for Health Care to help health insurers detect and prevent both opportunistic and professional fraud within the health care claims process.

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SAS® Health and Condition Management

To reduce medical costs – and the pain of afflicted patients – it is critical to identify ill patients or those likely to develop a chronic illness and act to stave off the onset of expensive complications. SAS Health and Condition Management delivers the information you need to predict risk, evaluate care management programs via the Web, align early intervention with at-risk stratification, and demonstrate measurable ROI across the enterprise.

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Ready to learn more?

Call us at 1-800-727-0025 (US and Canada) or request more information.