Title :
Leveraging Big Data Analytics to Reduce Healthcare Costs
Author :
Srinivasan, Uma ; Arunasalam, Bavani
Author_Institution :
Capital Markets Cooperative Res. Centre, Australia
Abstract :
The healthcare sector deals with large volumes of electronic data related to patient services. This article describes two novel applications that leverage big data to detect fraud, abuse, waste, and errors in health insurance claims, thus reducing recurrent losses and facilitating enhanced patient care. The results indicate that claim anomalies detected using these applications help private health insurance funds recover hidden cost overruns that aren´t detectable using transaction processing systems. This article is part of a special issue on leveraging big data and business analytics.
Keywords :
costing; data handling; fraud; health care; insurance; big data analytics; business analytics; electronic data; fraud detection; health insurance claims; healthcare cost reduction; patient care; patient services; transaction processing systems; Big data; Encoding; Information analysis; Medical information processing; Medical information systems; Medical services; Patient monitoring; Predictive models; big data; data mining; health data analytics; information technology; predictive modeling;
Journal_Title :
IT Professional
DOI :
10.1109/MITP.2013.55