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Health Plans Embrace Business Analytics to Thrive with Rreform

Thursday, April 28, 2011

Health care plans are recreating themselves, anticipating a consumer-driven world once health care reform takes effect in 2014. A recent study conducted by Stonegate Advisors for SAS, the leader in business analytics, suggests that navigating plans must focus on five strategic business drivers:

  • Predict shifts in their customer base.
  • Determine which exchanges to serve and how to compete.
  • Navigate the transition from wholesale to retail sales.
  • Manage the cost of care.
  • Collaborate more effectively with providers.

Because volumes of information are involved, advanced analytics are pivotal to plans' post-reform success or failure, according to Stonegate Advisors, a provider of research and analytics, strategic counsel and business advisory services to the health and wellness industry. 

"To be successful in a post-reform environment, health plans must proactively manage these strategic focus areas," said Stonegate Advisors President and founder Marc Pierce. "The successful evolution of health plans' strategies will firmly depend on their ability to improve the cost curve, manage and engage consumers individually, quickly develop innovative and affordable products, and navigate the dynamics of health reform."

Stonegate Advisors interviewed 40 key executives from 16 national and regional health plans. Results showed that effective integration and analysis of data will be instrumental to addressing the five strategic business drivers.

“Health plan executives know what will make or break them in the next several years,” said Sarah Rittman, Senior Health Care Industry Consultant at SAS. “It’s no surprise that strategic use of advanced analytics was a common thread. Effective use of advanced analytics can chart new, profitable paths for plans and SAS will lead the way. But without effectively leveraging data to take appropriate action and model best outcomes, many health plans that exist today will suffer or die altogether.” 

The full report, The Implications of Reform on the U.S. Health Insurance Industry, will be presented at the 8th Annual SAS Health Care & Life Sciences Executive Conference, May 11 and 12, in Cary, NC.

SAS in Health Analytics

SAS is the industry leader in health analytics software and services, delivering best-in-class solutions for improving medical care, strengthening financial performance, deepening customer relationships, and pursuing medical innovations. All of the top 25 health plans and pharmaceutical companies depend on SAS® for strategic insights into health outcomes, profitability, and customer preferences and behaviors that produce useful intelligence for business transformation and growth.

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 delivered within an integrated framework, SAS helps customers at more than 50,000 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® .
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