CASE STUDY

Healthcare Fraud, Waste & Abuse in Federal

Healthcare Fraud

Fraud, Waste, and Abuse in Healthcare Costs Billions Annually

Of the $2 trillion spent on healthcare in the United States annually, an estimated $60 billion is lost to healthcare fraud. This results in higher premiums and out-of-pocket expenses for patients, as well as increased insurance costs for employers. Even worse is the growing human toll: over six million Americans are addicted to prescription drugs, which account for over 40% of drug overdose deaths. In 2016, health care providers wrote over 214 million opioid prescriptions. For data scientists and healthcare data analysts tasked with researching fraud, waste, and abuse in healthcare, the challenge is data scale. Researchers armed with spreadsheets or traditional tools used for healthcare data analytics are unable to analyze the billions of prescription records, healthcare claims, or alternative data sources that could help identify issues and learn how to prevent fraud and abuse in healthcare.

 

DB-Turbo Version 5’s accelerated analytics platform cuts through billions of rows of records in milliseconds. This enables health scientists, data scientists, and other researchers and analysts to visualize, analyze, and truly interact with massive data sets to derive new insights aimed at public health services, abuse and overdose prevention, and criminal prosecution. For the first time, healthcare fraud analysis includes the geographic component of big data to determine which doctors, in which specialties prescribe, for example, specific quantities of opioids in selected cities, broken out by the drug prescribed. Multiple data sources can be overlaid on top of each other to render heatmaps in areas of high-risk for fraud, waste, or abuse, and to identify available resources and services to render aid and reduce healthcare fraud cases.

 

Few healthcare fraud software solutions can handle the torrent of big data required for effective analysis and prevention of fraud in the healthcare system. With DB-Turbo Version 5, public sector agencies have the power to rapidly research trends in big data, to render geospatial intelligence in milliseconds, or to accelerate their existing analytics solutions at the speed of curiosity. This unlocks a wealth of new use cases beyond Fraud, Waste, and Abuse in healthcare, such as All-Source Intelligence Analysis, Fleet Management, and Logistics Operations, to name a few.

 

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