Wednesday, December 1, 2010

Spatial predictive analytics helps find Medicare Fraud

It's staggering the level of Medicare fraud in the US.  IEEE Spectrum just published an article that describes a recent investigation by the FBI to uncover a fraud ring that were collecting improper payments by filing fraudulent claims to Medicare.  Of particular note to us is that the article calls out GIS and predictive analytics as a key tool in the fight against fraud.  The article doesn't go far enough to say that it takes modeling and analysis techniques in addition to the GIS software, but instead gives a plug to ESRI saying that their software is being used to plot these events.  Mere plotting is not enough, obviously, and the potential for more effective predictive techniques in the geospatial data environment is great in this area.  It's incumbent on all of us practitioners or OR and related disciplines to make sure that we are doing everything we can to make sure people know that there are more advanced methods than simple plotting and kriging.  I'm on the mission, hope you are too.

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