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: Other articles that will be of interest to readers.

Description: Information on the JRMS e-Library.

Description: Although crisis management remain often seen through a “communication lens”, it has in reality more in common with risk management than usually thought. Both crisis and risk management are anticipatory endeavors, with most of the work being carried out in peace time; both require a deep understanding of the organization’s activities and ecosystem; both have the same overarching objective to enable the organization to survive a brutal change to its usual operating conditions. Developing integration between the two functions would thus go a long way toward a more resilient organization.

Description: Hear from the editor’s on the December 2018 issue of Risk Management published by the JRMS.

Description: Risk Magnification does exist and needs to be considered in the risk aggregation and risk management processes.

Description: Financial institutions have and continue to suffer substantial financial losses because of their exposures to various operational risks and insufficient risk management. Quantifying operational risk is a critical component of an institution’s ability to manage risk. The model described in the article provides a numerical measure for operational risks existing in a business entity through statistical methods. It takes experience data to reflect both the general features and company specifics of the defined operational risks, while also allowing for managerial discretion. An important achievement is to suggest a level of capital to hold against potential losses arising from operational risks.

Description: The underlying premise of this paper is that enterprise risk management (ERM), as it continues to evolve as both a process and a collection of risk management techniques, can benefit from several different (but ultimately somewhat related) “megatrends.” The core of this paper concentrates on the impact on ERM of one of those megatrends: the emergence of a behavioral economics perspective, which is beginning to have a large impact on our understanding of the economy and on certain economic and business processes. The evolution and context of behavioral economics are described, and potential implications for the practice of ERM are discussed. The paper culminates with a variety of specific suggestions for ERM practice in response to findings from behavioral economics research, specifically a number of human cognitive dissonances inconsistent with traditional economic theory.

Description: Is Risk/Return a sound tool for decision-making? No. It is not consistent, not objective, distorts decision and degrades governance. Why? What shall we do then?

Description: ERM may exist in name only without a risk-aware culture. The article uses battle-tested approaches & behavioral insights to drive change and embed risk culture.