Case Study

Healthcare Advanced Analytics Helps Payer Identify $45M in Overpaid Claims from Fraud, Waste and Abuse

Healthcare Advanced Analytics Helps Payer Identify $45M in Overpaid Claims from Fraud, Waste and Abuse

The Business Challenge The US spent $2.7 trillion on healthcare in 2013, more than 17 percent of GDP. According to a Commonwealth Fund study, despite the high spending on health care, Americans have poor population health compared to other high-income countries (indicated by low life expectancy at birth, chronic conditions, obesity rates, infant mortality, etc.). One of the reasons is fraud, waste and abuse, which diverts significant reso

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