eBook: Payers and Providers
Using Data Analytics to Identify Fraud & Waste

Electronic health data has quickly become one of the healthcare industry's most valuable assets. The challenge now lies in how payers and healthcare organizations can systematically analyze this information to uncover game-changing insights that can drive clinical and operational efficiencies. In fact, the McKinsey Global Institute estimates that big data analytics can help the U.S. healthcare industry save more than $300 billion each year.

Savvy payers, hospitals and healthcare systems are increasingly using analytics to connect the hidden dots between such variables as patient characteristics, care gaps, treatments and even data investments to dramatically impact outcomes and costs.

This eBook examines how payers and providers are mining EHR data, claims activity, cost data and more to identify fraudulent activities, wasteful processes, and hidden inefficiencies at all points along the care continuum.

Table of Contents:

  • Analytics & Investigations: Two Pieces of One Puzzle
  • Data Analysis: Routines That Work
  • Case Study: Homegrown Software Automates Data Collection at Cincinnati Children's Hospital Medical Center
  • Data Analytics Poses Big Challenges, But Offers Big Rewards
  • Q&A: For Aetna, Data-Mining to Prevent Fraud Makes Both Dollars and Sense

By providing deep dives on timely industry issues, Fierce eBooks are valuable educational tools. They are designed to be easily read online - but also are formatted so you can print them out and take them with you. Fierce eBooks are assembled like a magazine, read the whole thing cover-to-cover, or pick and choose the articles that interest you most. Either way, they're a great one-stop resource.

Complete the form to the right to download your copy today!


Sponsored by: