Spotting fraud through better data analytics

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HHS' cloud-based fraud and analytics platform is playing an essential role in developing integrated operations to better understand and prioritize investigations of waste, fraud and abuse.


Data, Analytics & Visualization Finalists

FEMA Hurricane Journal
Federal Emergency Management Agency, Department of Homeland Security

Fraud and Analytics Platform
Office of Inspector General, Department of Health and Human Services

Operating and Support Management Information System
Deputy Assistant Secretary of the Army for Cost and Economics, Army

Self-Service Data Sharing and Visualization
Ohio Department of Administrative Services

U.S. Electric System Operating Data Tool
Energy Information Administration, Department of Energy

 

Click here for the full list of 2017 Dig IT finalists for all categories. And please join us at the Oct. 19 Dig IT Awards gala.

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.

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