Data can offer a clear picture of actual provider performance. Evaluating physician and other provider performance is a matter of scrutinizing the data using industry research to learn what to look for. In fact, leveraging published industry research is the way to skip the laborious and expensive regression analyses and other predictive modeling methods.
We have to get better at preventing and identifying insurance fraud, and waste and abuse in government programs. Having the right staff, coupled with best practices and a robust advanced analytics system on the front end of your business process, will only ensure your success.