SAS® Business Analytics give ‘Blues’ an advantage as US health insurance industry considers change

Blue Cross and Blue Shield insurers overwhelmingly seek benefits of the SAS Business Analytics Framework

CARY, NC . – With the entire US health care system under the microscope of reform efforts, key parts of such change firmly depend upon health insurers controlling costs, improving health care outcomes and maximizing member satisfaction.

Nearly all of the Blue Cross and Blue Shield licensees use SAS® Business Analytics to drive those measures.

Of the 39 companies within the oldest and largest family of health plans, all but four have deployed SAS software. One in three Americans -- more than 100 million residents -- counts on a Blue Cross and Blue Shield company for health coverage. And most BCBS insurers count on SAS, the leader in business analytics.

Among the health care insurance companies that drive their businesses with SAS business intelligence, data integration, analytics and solutions are BCBS companies in Florida, Nebraska, California, Minnesota, Pennsylvania, Massachusetts, North Carolina, New York and others.

“With increasing pressure from health care reform for health insurers to cut costs and invest in modern technology architecture, technologies such as advanced analytics are increasingly a key element in cost control,” said Kunal Pandya, Senior Analyst, Health Insurance Practice at Aite Group, an independent business technology research firm. “For health care insurers, such technologies can greatly assist with detecting fraud, proactively managing risk driven by preventative interactions and other areas that make the system more efficient and effective.”

The SAS Business Analytics Framework is a powerful blend of data integration, analytics, reporting and an ever-expanding portfolio of industry and line-of-business solutions. Organizations can quickly address immediate business issues, extending their use of SAS over time to achieve continuous performance improvements.

Some SAS technologies provide a powerful foundation for companies to build their own applications. Other SAS solutions answer industry wide needs for cost savings, patient welfare and other issues. SAS solutions applicable to all health care insurers include:

* SAS® Customer Intelligence improves member interaction and services.
* SAS® Fraud Framework for Health Insurance helps ensure that only valid claims are paid.
* SAS® for Disease Management predicts risk and optimizes interventions to achieve improved outcomes.

Obvious Benefits

Excellus BlueCross BlueShield uses the SAS Business Analytics Framework in numerous functions, including actuarial services, a unit that analyzes the company’s risk as it insures people in 31 counties in New York state. SAS Business Analytics technology allows Excellus to now examine not only what happened in its business, but also to predict what will happen.

“Insurance is dependent on the ability to identify and estimate future risk, and as a company we’ve always done that, but with SAS we can perform standard actuarial tasks at least 40 percent faster,” said Joseph Randazzo, Excellus Manager of Actuarial Services. “With that time savings we’re now able to perform analyses that were too time-consuming in the past. The benefit is obvious: We’re able to better control risk for our health plan.”
Better Information = Better Health

Serving 3.6 million members, Horizon Blue Cross Blue Shield of New Jersey is like many heath plans whose members are asking for increasingly complex and sophisticated information to control costs through care management programs. The increased demand for reports and automated dashboards was becoming a heavy burden for Horizon until it deployed SAS Enterprise BI Server.

The insurer started realizing a return on its investment within the first three months. More important were the incalculable benefits of improved information for Horizon executives and customers, said Mike Occhipinti, Horizon Manager of Informatics.

"The business analytics supplied by the informatics group support 70 major corporate projects. Achieving 5 percent more value for just one project can be worth millions,” he said. “Just three months after we installed SAS we were delivering automated disease management and health reports for major customers. This information is extremely important to improved health outcomes.”