The Evolution of Data and the Impact on Fraud Investigations
May 30, 2016
As the instances of fraud increase across the health care industry, many organizations and investigators are collecting data from various sources in order to gain better insights. Being able to collect, categorize and utilize this data remains a key method of staying ahead of fraudsters.
In this post, we talk with Mark Starinsky, Program Manager, Program Integrity Solutions, for General Dynamics Health Solutions. He’s responsible for detecting and investigating fraud, waste and abuse, as well as preventing improper payments in support of clients.
What are some of the biggest challenges facing the health care anti-fraud industry right now?
Our biggest challenge is staying ahead of the fraudsters. Three emerging areas that are particular challenges to the industry right now are the growing prescription drug abuse epidemic, the effect of health care expansion to underserved groups and the transition by health payers to value-based models.
Read the entire article from SmartBrief.
Mark Starinsky, Program Manager, General Dynamics Health Solutions
Personally, my feeling is “the more data, the better.” However, you must be able to understand what you’re looking at to benefit from the data; otherwise it can complicate your investigation."
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