Gartner Research

Best Practices for Healthcare Payers Addressing Fraud, Waste and Abuse

Published: 02 February 2015

ID: G00273112

Analyst(s): Manav Sachdeva , Robert H. Booz, Constance Sjoquist


Fraud, waste and abuse cost the U.S. healthcare system more than $60 billion every year. Healthcare payer CIOs can address this growing problem by improving awareness, increasing oversight and applying better technologies.

Table Of Contents
  • Key Challenges


  • Fraud, Waste and Abuse: A Business-Critical Problem for Healthcare Payers and Their CIOs


  • Develop a Comprehensive FWA Strategy
    • Real-World Issues in Developing the Strategy
  • Implement an Iterative, Multilayered Approach to Pre- and Postpayment Investigation
  • Create a Dedicated SIU

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