How SAS® Helps Modernize Medicaid Management
SAS enables government health care organizations to improve the lives of those they serve by combining disparate data and deploying advanced analytics and artificial intelligence to drive faster and more productive insights. Use data-driven decisioning to:
Provide better care
Achieve intended outcomes in the face of internal and external constraints.
Close care gaps
Leverage Medicaid focused models to isolate variables impacting access
Strengthen program integrity
Detect and prevent fraud, waste and abuse before money goes out the door.
Reduce costs
Effectively manage costs, optimize resources, and demonstrate effectiveness faster.
Save taxpayer dollars
Use state-of-the art advanced analytics and AI to help you recover millions of taxpayer dollars.
Why choose SAS for Medicaid modernization?
SAS has successfully integrated flexible solutions within state and vendor systems across the country. We focus on bringing large amounts of data stores together to help drive effective collaboration and data driven decision making.
Any solution can show you what your data is, but SAS can help show you what your data means! A comprehensive solution powered by SAS Viya can help identity sophisticated fraud schemes faster, target payment integrity issues and help contain costs. Use advanced analytics with embedded artificial intelligence and machine learning to spot problems faster and to better address Medicaid program risks.
Gain holistic data insights and enhanced information credibility.
The SAS Viya platform’s enterprise data warehouse and decision support system create a single source of truth data store to perform data preparation, advanced analytics and visualization.
- Seamlessly integrate any enterprise data source and apply embedded data quality techniques to improve accuracy and strengthen decision-making.
- Gain a holistic view of a recipient or provider to better detect anomalies or discrepancies across government programs or systems.
- Enable data scientists with varied programmatic skill sets to work in their preferred programming language including open source.
- Visualize care gaps and pinpoint risk factors faster with Medicaid models and dashboards.
Prevent improper payments and reduce waste.
SAS uses state-of-the-art analytics tools to assist Medicaid programs in detecting fraud, waste and abuse that would otherwise go unnoticed. That can help you optimize resources, reduce costs, and recover millions of taxpayer dollars.
Our hybrid approach combines anomaly detection, rules and predictive modeling to identify fraud, waste and abuse earlier than traditional methods by applying:
- Logic based rules. Ensure that known schemes are detected with a program integrity solution that includes an embedded rules library.
- Unsupervised learning. Proactively spot outliers among related groups and identify where fraudulent activities may be occurring.
- Machine learning models. Get faster, better modeling results from our solution, which includes industry best practice predictive modeling templates, hyperparameter autotuning and embedded model interpretability – all accessed through an intuitive interface.
- Network analytics. Quickly recognize underlying entity relationships and uncover schemes that cannot be detected by analyzing the billing patterns of individuals alone.
Learn More About How SAS Helps Modernize Medicaid Management
Featured Solution
SAS Payment Integrity for Health Care
Prevent, detect and manage payment integrity issues from every angle.
SAS Payment Integrity for Health Care is a single, integrated solution with components for fraud detection, alert management and case handling. Plus enhanced AI capabilities, such as automation for built-in intelligence, simplicity, collaboration and transparency.
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Solution Brief
Strengthen your state budget by quickly detecting and preventing fraud and improper payments
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