The US spends nearly $400bn annually on pharmaceutical drugs. Some estimates put the amount of fraud waste and abuse (FWA) above 30% of that.[1] While recent trends point to a slower rate of increase in pharmaceutical spending, there is considerable opportunity to remove wasteful and fraudulent spending on pharmaceuticals. Health analytics provide precise, scalable solutions … Continue reading Pharmacy Fraud Waste Abuse
Category: analytic methods
Applying AI in real “healthcare” world
My previous post discussed Challenges to doing ML in healthcare. This one suggests ways to apply AI in that overcome these challenges to realize the potential of AI in the real “healthcare” world. Strategically Choose use cases well, and design to get quick wins to prove ROI early. You will likely encounter a lot of resistance to … Continue reading Applying AI in real “healthcare” world
Challenges to applying ML in healthcare
A number of trends have paved the way for increasing adoption of machine learning (ML) in healthcare. We’re capturing more volume and types of health data than ever. Software for ML are evolving fast. Hardware advances have made the computing power cheaper, more agile, modular and scaleable than ever. However, despite these significant advances, adoption … Continue reading Challenges to applying ML in healthcare
A health data whisperer’s tricks
Some of you may remember the 1998 movie The Horse Whisperer. In it, Robert Redford’s character, who had a remarkable talent to understand horses, was able to help a horse and its owner overcome fears and recover from a tragic accident. It’s a lovely slow paced movie, well worth enjoying a popcorn over 🙂 In … Continue reading A health data whisperer’s tricks
Health Insurance Analytics Metrics
Health insurance is primarily in the business of receiving premium from policyholders and paying for their medical expenditure. To do that, the health insurance companies need to ensure that the premium charged is sufficient to pay for these medical and administrative costs. Analysts new to health insurance might find these concepts difficult to grasp. Some … Continue reading Health Insurance Analytics Metrics