SAS for Employer Reporting reduces employer insurance costs

Web-based, self-service software is first step in initiative to boost overall profitability, appeal of health insurance plans

Johannesburg, South Africa  (27 Jun. 2008)  –  SAS, the leader in business intelligence, unveiled this week its SAS Health Plan Intelligence initiative directed at increasing competitive advantages for health insurers and assisting their customers with control of rising medical costs. As the first offering in the ongoing effort for health insurers, SAS unveiled SAS for Employer Reporting, a powerful Web-based solution for analysing and reporting on medical claims and enrolment data.

The new software, when deployed by a health insurer, provides health plan customers a secure self-service request and delivery portal for employer reporting and analytics. The Web-based software provides: prebuilt, scheduled reports; customised reports, interactive reports and advanced analysis such as point-and-click forecasting.

The variety of reporting options can analyse and present historical data, but an even more vital feature is the software’s ability to transform that data into keen insight for successful decision making. This unique use of predictive analytics, a hallmark of SAS technology, lets health plan administrators be more proactive once they have spotted troubling trends, such as declining enrolment or excessive increases in costs for a certain disease population. 

Health plans benefit by being able to shift resources from report production to consultation, which allows plans to bring greater value to customers. Rather than supplying stacks of reports, health plan staff members have the opportunity to analyse and “tell the story” behind each customer’s trends.

For example, instead of simply reporting that outpatient per-member per-month costs are on the rise, the health plan can explore the underlying cause. By determining that cost increases are tied more specifically to increasing outpatient emergency room use by asthmatic children of employees in a particular city, the health plan creates information on which it can act. The health plan can use this information to engage their employer customer in discussions to implement an asthma management program.

Health plan customers benefit by being able to monitor and forecast cost and utilisation trends on demand. By understanding the potential impact of trends on insurance premiums, employers can work proactively with health plans to implement effective, customised cost-control programs.

“Health plan customers are constantly looking for ways to contain costs in today’s economy where every dollar counts. SAS Business Intelligence solutions have allowed companies in diverse industries to drive cost savings and improve organisational profitability,” says Richard Pro, SAS Health Plans Principal. “With SAS for Employer Reporting and subsequent products, we are bringing the power of predictive analytics to health insurers and their customers.”
“Instead of reviewing historical trends, health plan customers can forecast the future behavior of health system utilisation patterns and associated health costs. Health plans can model physician practice pattern variations, develop and manage condition management campaigns, and score claims for the likelihood of fraud or abuse prior to payment,” says Pro.

Several additional solutions to address the critical business issues of health insurers and their customers are now under development as part of the SAS Health Plan Intelligence Initiative. These include offerings targeted at disease management, fraud and abuse management, and others.

SAS for Employer Reporting is available as an offering hosted by SAS, with fast deployment and low cost of entry, or as a licensed software product for installation on an insurer’s server for customer access. SAS customer Blue Cross and Blue Shield of Florida is currently using Employer Reporting as a hosted service.

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