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: The article is based on a study of causes of insolvency and decisions made by management, regulators, and policyholders over the life cycle of the insolvency.

Description: Other articles that will be of interest to readers.

Description: Increased attention was paid to regulatory capital with the global financial crisis in 2008. Whilst companies may not have the incentives to retain a large amount of capital in the absence of regulatory capital requirements, overcapitalized entities can have drawback such as its impact on competitiveness. There are other weaknesses in the regulatory capital model such as its limitation in facilitating risk-based decisions as regulatory capital does not necessarily reflect the economic reality and risks an entity faces. Nonetheless, there are ways for regulators and/or companies to handle the weaknesses in the regulatory capital model. For instance, granularity can be introduced in determining regulatory capital. Economic capital can be used to encourage entities to implement risk management controls and facilitate risk-based business decisions (e.g., risk-adjusted performance assessment and risk-based capital allocation). Ultimately, hav ing effective risk management and risk-based capital determination are ways to prevent company failures and bankruptcies.

Description: Many top-performing businesses aren’t just risk aware, but rather risk intelligent. Such a posture helps prepare companies for a major event and can demonstrate to a regulator or auditor that an appropriately strong control framework is in place. Better still, companies gain real strategic value from a “risk adjusted” understanding not only of their threats and vulnerabilities, but also the upside opportunities associated with various risks. It starts with having both qualitative and quantitative information to identify, assess and manage risks. Strategic risk management, at its core, is about creating value by increasing transparency and accountability, and quality of information. More than a mere compliance exercise, effective risk management enables more informed strategic decision making, increased accountability and transparency, a greater likelihood of organizational success, and – ultimately – competitive advantage, as borne out by many studies that correlate risk management and financial results.

Description: This article discusses key considerations to build an incentive compensation program.

Description: A collection of essays that discuss the principles and ideas underpinning the ORSA initiative and the risk metrics used for decision making.

Description: Essays advocating for incentive compensation linked to the level of risk in an organization.

Description: Introduction and table of contents of essay collection.

Description: A sound enterprise risk management (ERM) framework functions as an ecosystem by balancing the interdependencies of its elements while constantly adapting to an ever‐changing, external environment. Each stakeholder has a unique role to play in forming a thriving ERM ecosystem by integrating risk‐conscientiousness in decision‐making. A resilient ERM framework has a single well‐ understood risk language and culture to promote healthy risk‐taking behaviors. The central focus of such a framework is concentrated around all stakeholders and everyone is held accountable. Every day, external forces can potentially disrupt how we operatively conduct business. Unforeseen changes in regulation, market trends, terrorist’s attacks and extreme natural disasters are often categorized as extremely adverse. How then will your ERM ecosystem survive the one‐in‐200 event and continue to flourish through dynamically changing environments?