SAS, The Cure for Growing Pains at MDwise

MDwise Inc., an Indianapolis-based not-for-profit managed care organization, had a growing problem. To provide the best care, MDwise needs to understand its patients while also sharing relevant information on them with state regulators and its network of healthcare providers. But a new contract with the state of Indiana meant that MDwise (pronounced “MED-wise”) was expanding from a regional to a statewide provider, with more patients, more providers in its network, and more diverse data sources to integrate, analyze and share. 

MDwise turned to SAS to cure its growing data pains. Through a combination of SAS BI and data integration software, MDwise is solidly positioned for growth. 

“SAS helps MDwise integrate sources that are not easily integrated. No matter the data format or the system, SAS helps us seamlessly bring together data, analyze it and turn it into intelligence which we can act upon and share with state regulators and our network of providers,” says Rush Daugette, Director of Information Services at MDwise. “Whether we’re submitting claims data to the state under our new Hoosier Healthwise contract or sharing enrollment files with our providers, MDwise has the power of SAS business intelligence and data integration behind it to easily do all that we need to do.” 

Complete and accurate data
In 2006, MDwise was selected to provide statewide Medicaid services for the Indiana Family and Social Services Administration’s Hoosier Healthwise program, Indiana’s health coverage program for low-income families and children. Under the new contract, which started Jan. 1, 2007 and runs through 2010, MDwise serves more than 245,000 eligible Hoosier Healthwise Medicaid members. As a result, MDwise needed to expand its reach from an existing network of regional hospitals in central and northwest Indiana to a statewide network of health providers.

A challenge for MDwise and for its Information Services team has been to ensure that complete and accurate data – on the number of patients and the care provided them – could be gathered from its growing network of managed care providers and shared with the state of Indiana, which pays MDwise based on the number of patients served each month. 

With SAS Enterprise BI Server software, MDwise’s Information Services team can react quickly to requests from its provider network, analyze Medicaid claims data and see that the state receives accurate information. 

Through SAS BI and data integration technologies, MDwise can bring together its existing systems with those of new providers added to the care network as a result of statewide expansion. Daugette and his team can create a single, accurate picture of the people MDwise serves, and securely share data and intelligence with its provider network, its medical directors and its partners in the state government.