DIG IT AWARD FINALIST: DATA, ANALYTICS & VISUALIZATION
Spotting fraud through better data analytics
- By Ben Berliner
- Oct 11, 2017
In July, the Department of Health and Human Services’ Office of Inspector General helped uncover a Medicare fraud scheme that totaled $1.3 billion. Over 400 individuals in 41 federal districts were charged. HHS officials say such efforts to defraud the federal health care system are a growing problem, and they are turning to data analytics to help them more fully understand and ultimately stop the schemes.
To gain deeper insights into the data HHS collects, the OIG created a cloud-based fraud and analytics platform that provides users with centralized, accessible information in the form of a data visualization dashboard. The platform is creating an environment in which employees can conduct in-depth data analysis, and it is playing an essential role in developing integrated operations to better understand and prioritize investigations of waste, fraud and abuse.
HHS is using a combination of agile development, DevOps and open-source technology to make the most of its data, improve the prosecution of fraud cases and enhance the recovery of the stolen money. New features undergo multiple rounds of testing, and HHS solicits input from users and stakeholders before deploying them.
As health care systems become more complex, criminals are using more sophisticated methods, which means HHS faces an urgent need to expand its fraud detection capabilities. Officials have noted that fraudsters frequently copy techniques from one another, so connecting multiple internal data sources and making them more accessible will give investigators a more holistic view of the data and help them identify trends.
In the end, the platform will help HHS curb fraudulent activity, save taxpayer money and protect federal health programs.
Ben Berliner is a former editorial fellow at FCW. He is a 2017 graduate of Kenyon College, and has interned at the Center for Responsive Politics and at Sunlight Foundation.
He can be contacted at [email protected].
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