Description: This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for fraud detection in Medicare.

Description: We highlight a new approach leveraging predictive analytics to identify high risk and rising risk opioid users for more effective screening and follow-up care.

Description: Panel discussion about ways can insurance carriers and health care coalitions work together, what data are coalitions requesting from health carriers, how health carriers respond to those requests, and implications for health carriers.

Description: Presented at October 1986 Annual Meeting. This session discussion is about the state-of-the-art in packaged software, the requirements of such systems, and current and future health care developments that must be addressed.

Description: Recent health care reform activity has highlighted the importance of Clinical Integration in improving the quality, safety, efficiency and reimbursement infrastructure of the health care system. This article discusses relevance and implication of regulatory measures, implementation and data issues, and provides an end-to-end example.