CareSource improves patient care, costs using SAS® analytics

CARY, NC  (Jun. 03, 2009)  –  Some patients use health care in ways that may be ineffective or even dangerous. Medicaid managed health care plan CareSource, uses SAS® analytics to identify such patients. The major Ohio-based not-for-profit observed that patients with chronic health conditions often visit hospital emergency rooms repeatedly. With SAS, CareSource identifies such patients rapidly so that interventions can be made to improve patient care while reducing costs.

“Using SAS, we discovered one patient with 27 doctor visits in one month and 30 prescriptions – seven just for asthma,” said Cathy Meade, Director, Decision Support and Informatics at CareSource. “Some were taking medicines prescribed by different doctors that were contraindicated. Other patients who visited the ER many times for headaches had more CAT scans than is healthy.’’ 

Before SAS, CareSource struggled to determine who needed care management services. “Case managers would scroll through hundreds of pages looking for test authorizations, notes from primary care physicians and claims for clues,’’ said Meade. “It was difficult and time-consuming.’’ CareSource needed an analytic framework that could handle data collection, analysis and reporting. 

SAS helps the company identify patients that need a more strategic treatment plan. It also helps physicians’ better care for patients by providing customized care treatment plans.  CareSource also uses SAS to provide clinical practice reports that inform physicians of patients who need various types of preventative services.  Prior to the SAS solution, the process was managed through multiple reports, each one specific to a particular treatment need. 

Today, physicians receive reports on all their Medicaid patients. Reports show which children need lead testing and which diabetics are overdue for a blood sugar test. They see if patients are visiting the ER for routine care and other key preventative measures that assist with identifying gaps in necessary care a member should receive. With this information, many CareSource network physicians are calling patients to schedule follow-up appointments and testing.

To make it even easier for physicians to track and treat patients, CareSource is also using SAS to create a customized report that can be printed and dropped into a patients chart or attached as a PDF to their electronic medical record real time. ”SAS helps us be more effective by letting us pull everything together into a single document,” said Bob Gladden, CareSource Vice President of Information Management and Analysis. “It’s easier for us and the physician, and builds more effective partnerships with doctors and our members.’’

The next step is to use SAS forecasting to expand upon efforts underway to identify members at risk of developing illnesses like diabetes and get them into the care management system before the disease develops. 

“We want to save money, but as a non-profit, mission driven organization that isn’t our primary goal,’’ Gladden says. “We’re really concerned about facilitating better care for members. SAS is a mission-critical component of that effort.’’

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