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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 But inefficient business processes, lengthy claims processing and outdated information management strategies are proving to be formidable roadblocks to demonstrating value to those who purchase healthcare benefits.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.
Such predictive power is available to you from SAS. Our solutions provide a gateway to business intelligence, enabling you to gather data from your existing transactional foundation systems and transform it into critical business knowledge.
SAS solutions for health insurance are comprehensive, offering everything you need
to make solid business decisions, align actions with business strategy, improve
your operational efficiency and, ultimately, increase your bottom line results:
Customer Intelligence
Identify your most profitable members and employer groups, determine which
agents bring in the most members and predict which members will leave your
health plan.
 Customer Relationship Management. With SAS
Customer Relationship Management solutions, you can conduct more effective
customer interactions, increase awareness, improve targeted marketing and
enhance customer services.
Operational Intelligence
Achieve sustainable operational improvements so you can price services optimally,
enable new business strategies, reduce operating costs, improve performance,
track progress toward achieving organizational goals and meet service level
commitments. With SAS Operational Intelligence solutions for health insurance,
you can improve your IT infrastructure management and enhance operational efficiencies.
Health Plan Reporting. Empower your customers with self-service
reporting functions that let them answer their own questions about health
benefits costs and plan utilization. SAS for Health Plan Reporting relieves
your reporting burden by giving employer groups direct access to the information
they need in an on-line, self-service format.
Health Plan Intelligence
Make sense of your complex challenges by analyzing and uncovering cost and
funding balances; understand the factors that affect premium costs and program
rates; align book-of-business and line-of-business profitability; and predict
activities related to fraud before they occur. With SAS' powerful analytic
capabilities, your organization is better equipped to meet its goals for reducing
costs and raising profitability and return on investment.
Health Insurance Fraud. Reduce claims costs and losses due
to fraud by making predictive, accurate claims decisions before claims
are paid. SAS
for Health Insurance Fraud goes beyond traditional rules-based fraud
detection solutions to offer advanced analytics and easy integration with
your claims payment processes for improved recovery and prosecution efforts.
Health Informatics Intelligence
Effectively manage clinical risk by uncovering early indicators for illness,
anticipate future utilization of clinical services, improve reimbursements
for contract negotiations, and analyze clinical outcomes and medical expenses
to reward provider performance. SAS solutions for health informatics intelligence
supply the tools you need to proactively understand which factors are most
important for reducing risk and predicting future areas of improvement.
Disease Management. Effectively manage clinical risk and
gain control of high-cost diseases by uncovering early indicators for illness.
With SAS for Disease Management, you can predict risk and optimize interventions
in order to achieve improved outcomes.
Beyond BI™
For health insurers, traditional business intelligence is not enough to meet
today's market demands. SAS takes health insurers Beyond BI™, providing
you with forecasting, predictive modeling and optimization capabilities so
you can evolve from simple historical benchmarking to truly predicting what
will happen next and understanding the best that can happen.
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Industries
Aerospace
