SAS Unveils AI-Powered Solution to Help Healthcare Payers Optimize Cost and Quality of Care

SAS, a leader in data and AI, has unveiled a new solution – SAS® Health Cost of Care Analytics – aimed at healthcare payers and providers to facilitate effective decision-making regarding the quality and cost of care.

Set to launch in July 2025, SAS Health Cost of Care Analytics utilizes health claims data, allowing health care organizations to build and evaluate claims as episodes of care by integrating codes and patterns throughout a “care journey” from detection to treatment to care management. 

This healthcare analytics solution, developed on the SAS® Viya® data and AI platform, can promote more cost-effective treatment pathways, minimize unnecessary admissions, shorten hospital stays, and more.

SAS will present SAS Health Cost of Care Analytics along with other data and analytic solutions for health care payers and the industry at AHIP 2025 in Las Vegas.

According to Gartner®, “Payers increasingly require advanced data and analytics to achieve outcomes such as identifying rising risk populations, enhancing quality measure performance, managing the total cost of care, and personalizing experiences.”

“As healthcare incentives focus in on value, providers and payers must identify the drivers of cost, quality and outcomes to make decisions about protocols and provider contracts,” said Brett Davis, Senior Manager, Healthcare Advisory at SAS. “Going far beyond traditional claims grouping, SAS Health Cost of Care Analytics generates valuable insights to identify variations and opportunities for improvement when assessing financial risk, all while understanding members in more detail.”

Recently introduced to assist payers and providers, pre-built AI models are now available. Enhancing its healthcare solutions portfolio, SAS’ AI models leverage decades of experience in implementing scalable and reliable AI for practical applications, aimed at addressing business challenges with accuracy and effectiveness.

The newly available models include:

SAS Medication Adherence Risk: Identifies patients needing intervention for medication adherence, improving outcomes, quality metrics, and lowering costs.

SAS Document Analysis: Converts scanned medical documents into structured data, enhancing efficiency for medical reviewers and showing a 400% gain over manual review in one major insurer.

SAS Payment Integrity for Healthcare Detect and Prevent: Addresses billing errors, claim discrepancies, fraud detection, and improper claim prevention, helping meet regulatory compliance and manage costs.