SAS® Helps Health Providers, Payers, ACOs Improve Care, Lower Costs

SAS^® for ECR Analytics^TM software supports value-based reimbursement models

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“The significant variations in provider costs and clinical patterns complicate contract negotiations and quality measurement. With SAS, we can fully integrate surgeons and other health care professionals into all levels of care, creating possibilities for cost containment and quality improvement.”

Health care payers, providers and accountable care organizations (ACOs) can improve care quality and patient outcomes while holding down costs using SAS^® for ECR Analytics™, a new product from business analytics leader SAS.

“In every industry – whether banking, financial services, retail or health care – understanding and optimizing financial risk and reward is a data-driven exercise,” said Graham Hughes, MD, Chief Medical Officer for SAS Center for Health Analytics and Insights. “The more data you have, and the better you analyze it, the less likely you are to set unrealistic targets for either quality or cost. SAS for ECR Analytics leverages state-of-the-art analytic tools to help ensure that organizations adopting value-based payment models have a clear understanding of episode-based performance in order to confidently predict and manage the financial risks and rewards associated with this new wave of incentive-driven, value-based contracting.”

SAS for ECR Analytics enables health care organizations to:

• Accurately analyze clinically meaningful episodes of care for at-risk patient populations.
• Rapidly tailor existing episode definitions to enable flexibility when negotiating and setting case rates.
• Track actual against expected performance based on evidence-informed best practices and risk-adjusted for patient severity.
• Identify potentially avoidable care variations, complications and associated costs.
• Establish full transparency when creating achievable shared savings targets.
• Participate in – and manage – bundled payments, shared-savings ACOs and other new payment models.

An ECR (evidence-informed case rate) is a budget for an episode of medical care within a defined time period. The ECR includes all covered services across all providers that typically treat a given condition, adjusted for the severity and complexity of a patient’s condition. SAS for ECR Analytics currently includes more than 30 ECRs, from individual procedures such as joint replacements to treatment of chronic conditions such as diabetes and cardiovascular disease. SAS will add approximately 60 new episodes in 2013.

The new offering draws on the principles of the groundbreaking PROMETHEUS Payment^® system from the nonprofit Health Care Incentives Improvement Institute (HCI³), a pioneer in episode-construction and bundled-payment methodology. The re-architected solution, now with a more comprehensive and holistic view of patient care, streamlines the adoption of newly introduced value-based payment models that introduce greater levels of shared provider risk, including bundled payments and multiple types of capitated models such as those associated with most ACOs.

Horizon Healthcare Services Inc., New Jersey’s oldest and largest health insurer and an original PROMETHEUS Payment customer, recently purchased SAS for ECR Analytics.

“SAS for ECR Analytics helps us improve quality outcomes, increase patient satisfaction and reduce costs,” said Michael Occhipinti, Director of Informatics at Horizon Healthcare Services Inc. “The significant variations in provider costs and clinical patterns complicate contract negotiations and quality measurement. With SAS, we can fully integrate surgeons and other health care professionals into all levels of care, creating possibilities for cost containment and quality improvement.”

About SAS health analytics

SAS health analytics encompasses the technologies and skills needed to deliver business and clinical insights into the complex interdependencies that drive medical outcomes, costs and oversight. Through modeling, optimization, predictive analytics and business intelligence, organizations can strengthen financial performance, deepen consumer relationships and improve health care delivery for better outcomes across the entire spectrum of health industries. Visit SAS for Health Analytics for more information.

About SAS Center for Health Analytics and Insights

The SAS Center for Health Analytics and Insights (CHAI) is a strategy, research and incubation organization focused on identifying new ways of applying advanced analytics to the challenges facing the health care and life sciences industries. Through multidisciplinary collaborations and the world’s most powerful analytics software, CHAI helps organizations develop deeper patient insights, better medical outcomes, lower costs and improved organizational performance.

About SAS

SAS is the leader in business analytics software and services, and the largest independent vendor in the business intelligence market. Through innovative solutions, SAS helps customers at more than 60,000 sites improve performance and deliver value by making better decisions faster. Since 1976 SAS has been giving customers around the world THE POWER TO KNOW^®.

SAS and all other SAS Institute Inc. product or service names are registered trademarks or trademarks of SAS Institute Inc. in the USA and other countries. ® indicates USA registration. Other brand and product names are trademarks of their respective companies. Copyright © 2013 SAS Institute Inc. All rights reserved.