Radpidly increasing cases of Opioid overdose and high utilization, causing the overall deterioration of health and increasing the death rate across age groups in U.S. We need a smart system to detect and prevent the fraudulent activities to reduce the healthcare cost and waste, and improve the overall quality of healthcare services.
“Fraud accounts for 19% of the $600B to $800B in waste in the U.S. healthcare system annually. Each family in the U.S pays more than an extra $800 in health care costs each year due to healthcare fraud. Since 2008, Medicaid’s improper payment rate has averaged 8.4%, resulting in $161B worth of improper payments and accounting for more than 17% of all improper payments made by the federal government”- as per 2015 advizehealth.com article