At NHCAA’s 2013 Annual Training Conference, we polled 300 investigators, clinicians and other FWA experts across commercial, federal and local state agencies to better understand where we’re effectively fighting fraud, waste and abuse–and where we have room for improvement. Below are

the answers they provided. Ahead is the opportunity to put up a better fight.

WHEREWHAT

WHEN& WHY BE

HINDHEALTHCARE

FRAUD,WASTEAND ABUSE.

Every day, we lose nearly $1,000,000,000. That’s nearly $600,000 every minute.

FWA LOSSES, A BREAKDOWN

100 50 100 150 200

ANNUAL LOSSES BY INDUSTRY (IN BILLIONS)

Rx

Dental

Physician

Facility

Every year, over $300 billion is lost to healthcare fraud, waste and abuse in this country.

$300BILLION

WHERE CAN WEMOST IMPROVE OUR EFFORTS?

12%Greater government oversight

and regulation.

37%Increased transparency between

payers and providers.

The sharing of healthcare data across payers.

51%

OTHER RESOURCESARE REQUIRED TO HELP STOP FWA?

Other (Examples included: more tools, man-power)

3%

New software solutions and innovative technology.

55%New and evolving organizational

strategies and support.

42%

WHAT

WHEN THE ACA TAKES EFFECT, HOW WILL IT IMPACT FWA?

3%There will be a minimal impact in new

schemes or our ability to prevent FWA.

22%It will mitigate and prevent

future schemes and trends.

75%An increase in the emergence of

new schemes and trends.

WHY HAVE WE BEEN UNSUCCESSFUL FIGHTING FWA?

15%Other (Examples included: humanresources, organizational support)

40%Laws and bureaucracy prevent

us from real improvements.

45%There has been lack of innovation

in the tools we use to fight FWA.

To learn more about healthcare fraud, waste and abuse visit www.veriskhealth.com/fwa© 2014 Verisk Health

Cross-Payer CollaborationNew Technology Better Innovation

HOWREDUCE THE IMPACT OF FWA’S EFFECTS.

WE CAN