Who will help me save Datapolis?

Dr. Insight
Dr. Insight|April 17, 2012

The men, women and children of Datapolis are falling ill at an alarming rate, forcing me to turn my attention away from my ongoing battle with Obscuro and toward helping the Datapolis Council of Elders distribute its medicine before it is too late. As it happens, just as we most [...]

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What happens when a health care fraud scheme changes its spots?

Ross Kaplan
Ross Kaplan|February 22, 2012

In most of the articles and press pieces that speak of health care fraud, the topic is usually covered in broad terms regarding the type or activity that has taken place: over-billing to Medicare/Medicaid, services billed and not delivered, over subscription of medication (by members or Pharmacies), and the list [...]

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Is it fraud or abuse?

Ross Kaplan
Ross Kaplan|November 1, 2011

When discussing fraud and abuse, it often (very often) becomes a philosophical discussion of whether aberrant activities are fraudulent or abusive. The quick difference being that fraudulent is intentional and abuse is not.  The distinction quickly becomes an issue of legal and illegal as opposed to right and wrong. What [...]

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Contagion: Wash hands after reading

Trent Smith
Trent Smith|October 23, 2011

For the past year, I’ve had the pleasure of serving on the communications team of the National Collaborative for Bio-Preparedness (NCB-P), of which SAS is a partner and the analytics provider. That experience was heavy on my mind as I recently watched the film Contagion. I may drop some minor [...]

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Humble listening: an interview with the first SAS Chief Medical Officer

Alison Bolen
Alison Bolen|August 18, 2011

 As part of the staffing efforts for the new SAS Center for Health Analytics and Insights (CHAI), SAS recently hired Dr. Graham Hughes, MD, as the company’s first Chief Medical Officer (CMO). When I heard the news, I sent a few questions to Graham to learn more about the new [...]

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Why life cycle management matters for health care fraud analysis

Ross Kaplan
Ross Kaplan|July 7, 2011

Due to the rapid changes in both the health care market and more specifically the amount of fraud being committed in it, it is even more important than ever to maintain some degree of life cycle management to update the analyses used to detect and identify aberrant activity. However, many [...]

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Health care fraud is on the rise

Ross Kaplan
Ross Kaplan|May 12, 2011

In the health care field, the impact of fraud, waste and abuse on payers — whether insurance companies, government agencies or self-insured employers — is enormous. Fraud losses weaken a payer’s financial position, with fraud loss estimates rivaling net income. Fraud losses feed the escalating care cost curve, undermining a [...]

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Business Analytics 101: Enterprise Fraud Management

Ellen Joyner
Ellen Joyner|December 17, 2010

Recently I was listening to an NPR (National Public Radio) documentary about the history of cancer and medicine’s evolution in understanding and treating cancer. This was an amazing story. I would venture a guess that nearly everyone who is reading this post has been affected by cancer in one way [...]

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AHIP 2008 – IT WAS A BIG YEAR AND YOU’VE BEEN A PART OF IT

Rick Ingraham|June 22, 2008

I am back home in Denver and catching up on all my thoughts from AHIP 2008. Every year I come back wishing I could divide my time exponentially. After all, a quick count of this year’s session tells me that I could only scratch the surface. In total, the Institute [...]

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ACHIEVING PRECISION MEDICINE & LOWER COST THRU DISRUPTION

Rick Ingraham|June 22, 2008

Twice this year, I have been privileged to hear Clayton Christensen outline the principals around disruptive technologies and their impact on redefining industries. I left Friday’s closing day general session, “Diagnosing the Disease: A Disruptive Remedy for Health Care”, equally excited, reenergized yet perplexed. AHIP, again, did not fail to [...]

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