Advanced Computing in the Age of AI | Thursday, June 30, 2022

SAS Examines States’ Healthcare with Claims Analytics 

As we face the implementation of a new, reformed healthcare system, the ability to compare various plans has established itself as the movement’s backbone. However, the infrastructure thus far has been lacking, with few systems capable of effectively parsing through healthcare payment data. But SAS has stepped into the arena, armed with new software, to lend a hand.

With SAS’ Claims Analytics for APCD (all-payer claims database), the company hopes to bring representatives from government agencies, Capitol Hill, healthcare providers as well as their customers a way to easily compare claims information in order to help reduce costs and perhaps even boost quality of care.

Already health insurance exchanges are introducing the public to this type of system, but SAS expects this consumer culture will ultimately give rise to questions such as how much does a certain medical procedure cost in one county or state as opposed to another. Or, for policymakers, it can help to show whether there are enough physicians in a given location to meet the community’s needs.

These same circumstances have also led state governments to develop APCDs—statewide databanks for medical, dental and pharmacy claims for public and private healthcare payers.

“State governments and policymakers are realizing the benefit of harnessing big data to improve collaboration and transparency,” says Dr. Graham Hughes, chief medical officer for SAS. “Building price transparency into a state’s healthcare system requires an APCD that can withstand the rigors of big data. With reliable access to comparative information on cost and quality, policymakers are better informed and consumers have the power to choose—reducing healthcare costs and improving quality of care.”

To quickly visualize and analyze from these information repositories, the New Hampshire Institute of Health Policy and Practice (NHIHPP) at the University of New Hampshire turned to SAS. There, SAS Claims Analytics for APCD will help to identify areas where plans and providers differ, and create a data warehouse for storing claims and clinical data, which can then be visualized in memory with SAS Visual Analytics.

“The ability to quickly explore health data will greatly improve health care policy decision making,” says Josephine Porter, MPH, NHIHPP’s deputy director. “Our partner sites worldwide will soon be able to easily access and visually display population, cost and utilization data. This will enable our project partners to interpret and discuss results much more effectively. This system also advances transparency by letting the public view analyses at state and regional levels.”

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