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Sun, Sybase and SPSS Join Forces to Address Fraud Detection for Healthcare With End-to-End Analytical Solution


SAN DIEGO, Feb. 10 /PRNewswire-FirstCall/ -- Healthcare Information and Management Systems Society 2003 Conference -- Building on a history of collaborative successes, Sun Microsystems, Inc., Sybase, Inc. and SPSS Inc. have announced an analytical

SAN DIEGO, Feb. 10 /PRNewswire-FirstCall/ -- Healthcare Information and Management Systems Society 2003 Conference -- Building on a history of collaborative successes, Sun Microsystems, Inc., Sybase, Inc. and SPSS Inc. have announced an analytical business solution to help healthcare organizations detect and combat fraud, and may help them comply with their federally mandated Health Insurance Portability and Accountability Act (HIPAA) requirements. The three companies have collaborated to develop a fraud detection solution that helps enable healthcare organizations to minimize risk by detecting claimant and provider fraud using predictive analytics.

Since the early 1990s, healthcare fraud -- the deliberate submittal of false claims to private health insurance plans and/or tax-funded health insurance programs such as Medicare and Medicaid -- has been viewed as a serious and still-growing crime phenomenon, linked directly to ever-growing annual healthcare outlays.

The solution is based on healthcare fraud detection best-practice templates currently used to enable healthcare organizations to quickly detect a wide range of fraud, such as duplicate claims submissions; unbundling (submitting a claim for each procedure when only one is required); and ping- ponging (the sharing of a single patient ID to generate billings across multiple providers). The fraud detection solution can also help predict which medical practices within a provider base are most likely to be out of compliance, and identify claimants who are most likely to commit fraud.

"Every year, healthcare fraud creates enormous losses in a system that can ill afford to be losing any amount of revenue," said William Mahon, president and chief executive officer of the National Health Care Anti-Fraud Association (NHCAA). "We estimate annual loss to fraud for the healthcare industry to be between three and ten percent of total healthcare revenues. With our total national healthcare spend at $1.4 trillion in 2001, that translates to annual losses somewhere between $42 billion and $140 billion for the industry."

"Healthcare claim payers are taking strong action to combat fraud and abuse of the system in key areas, and analytic applications play a critical role in this effort," said Scott Zahl, vice president, Sun Business Group, GE Access. "The Sun, Sybase and SPSS solution, integrated and distributed by GE Access, provides the healthcare industry with a finely tuned and proven template for detecting and analyzing patterns of fraud in large corporate data warehouses. Preventing such fraud, we believe, will help combat a problem that costs the industry -- and taxpayers -- billions of dollars a year. We plan to replicate this template in a variety of other industries that will help grow our solution providers' business, and we look forward to collaborating with Sun, Sybase and SPSS on that continuing effort."

The Predictive Fraud Detection solution is comprised of Sun FireTMV480 and V880 servers, Sun StorEdge(TM) arrays, and the Sybase Adaptive Server(R)IQ Multiplex(TM) enterprise analytical engine -- optimized for performance with SPSS' data mining workbench, Clementine(R), and the Clementine Application Template (CATs) for fraud detection.

Availability and Support

Working with Sybase, SPSS and Sun, GE Access will integrate, test and ship a complete plug-and-play solution for the healthcare market. Ultimately, this offering will expand solution providers' ability to meet the needs of the healthcare industry and grow their own customer-base. General product availability is expected in March 2003.

About Sun Microsystems, Inc.

Since its inception in 1982, a singular vision -- "The Network Is The Computer(TM)" -- has propelled Sun Microsystems, Inc. to its position as a leading provider of industrial-strength hardware, software and services that make the Net work. Sun can be found in more than 100 countries and on the World Wide Web at http://www.sun.com.

About Sybase, Inc.

Sybase pioneers software that integrates platforms, databases and applications. Sybase solutions create Information Liquidity -- transforming data into economic value. With Sybase, companies can attain maximum value from their data assets by getting the right information to the right people at the right time. To learn more about Sybase, visit www.sybase.com.'

Sybase teams with industry-leading solution providers and developers to bring innovative technologies to market to help customers transform their data into economic value by improving the speed, flow and quality of data within an enterprise. Committed to the philosophy that partnerships should be mutually beneficial, Sybase's Business Solutions Alliance Program connects partners to the resources they need to profit from the relationship, including quality product, tools, training and access to marketing, business and technical support. To learn more about partnering with Sybase, please go to http://www.sybase.com/partner

About SPSS Inc.

SPSS Inc. headquartered in Chicago, IL, USA, is a multinational computer software company providing technology that transforms data into insight through the use of predictive analytics and other data mining techniques. The company's solutions and products enable organizations to manage the future by learning from the past, understanding the present, as well as predicting potential problems and opportunities. For more information, visit www.spss.com.


Sun, Sun Microsystems, the Sun logo, Sun Fire, Sun StorEdge and The Network Is The Computer are trademarks or registered trademarks of Sun Microsystems, Inc. in the United States and other countries. Sybase, Adaptive Server, IQ Multiplex and Industry Warehouse Studio are trademarks of Sybase, Inc. or its subsidiaries. Clementine is a registered trademark of SPSS Inc.(R) indicates registration in the United States.

Special Note: Statements concerning Sybase and its subsidiaries' contemplated business relationships, new product releases, and business expectations are by nature forward-looking statements that involve a number of uncertainties and risks and cannot be guaranteed. Certain of these risks are detailed from time to time in Sybase's Securities and Exchange Commission filings, including but not limited to its annual report on Form 10-K and its quarterly reports on Form 10-Q (copies of which can be viewed on Sybase's Web site).

Sybase, Inc.

CONTACT: Hadley Weinzierl of Citigate Cunningham for Sybase, Inc.
+1-617-374-4219, hweinzierl@cunningham.com, HIMSS Booth # 1827;
Liza Santos, Volume Systems Products, Sun Microsystems +1-415-972-0624,
liza.santos@sun.com, HIMSS Booth # 1017; Kim McLynn of SPSS Inc.,
+1-312-651-3804, kmclynn@spss.com, HIMSS Booth # 4207; Frances Freyberg,
Healthcare, Sun Microsystems, +1-650-786-3471, frances.freyberg@sun.com, HIMSS
Booth # 1017

Web site: http://www.sun.com/.



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