Government Health Care Solutions

Saving lives, improving outcomes and controlling costs through data-driven policy decisions.

Modernize Medicaid Management

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.

Accelerate innovation using an AI, analytics and data management platform running on a scalable, cloud-native architecture.

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.

SAS in the Public Sector – Facts & Figures


public sector departments, ministries, offices & agencies using SAS worldwide


US state governments using SAS to solve their most complex problems


countries rely on SAS in the public sector for reliability and accuracy

Recommended Resources for Modernizing Medicaid Management


Make smarter, faster decisions in Medicaid management

Take a fresh look at how analytics helps leading Medicaid agencies make the rapid, data-driven decisions needed to manage increasingly complex programs.


The transformational power of evidence-based decision making in health policy

Health care agencies are adopting data and analytics to improve outcomes and control costs

Solution Brief

Strengthen your state budget by quickly detecting and preventing fraud and improper payments

Discover how to thwart today’s sophisticated fraud schemes and methods by consolidating data from internal and external sources on providers and beneficiaries, coupled with advanced analytics.

White Paper

Fighting the Rising Tide of Medicaid Fraud

Medicaid fraud has jumped dramatically in the era of COVID, and states must respond by accelerating their deployment of big data, predictive analytics and integrated technology platforms to manage Medicaid programs and prevent fraud. This white paper explores the challenges and opportunities this presents.


Fingerprints in Your Data

Medicaid fraud has jumped dramatically in the era of COVID, and states must respond by accelerating their deployment of big data, predictive analytics and integrated technology platforms to manage Medicaid programs and prevent fraud. This white paper explores the challenges and opportunities this presents.

White Paper

Performance at Scale: Comparing AI/ML Performance of SAS Viya vs. Alternatives

There are several important trends for businesses today including cloud computing, the move to containernnative applications and the use of Artificial Intelligence. SAS® Viya® sits at the intersection of all three trends by offering an advanced AI solution that can operate in both public and private cloud environments running as a containerized cloud native application.

Connect with SAS and see what we can do for you.