What tools are available to help us manage fraud, waste, and abuse?

We are integrating data analytics, clinical services, and case management to help identify and act on fraud, waste, and abuse earlier and more effectively.

HOW WE HELP

THE PROBLEM

Fraud, waste, and abuse (FWA) is a national epidemic that costs our healthcare system at least $200 billion every year. These costs are borne by plans, employers, providers, members -- all of us.

$ 270 Billion

Estimated cost of healthcare fraud, waste, and abuse

Identifying fraud, waste, and abuse early.

MedImpact uses artificial intelligence and machine learning to analyze data across pharmacies, prescribers, and members and identify suspicious claims before they are paid. We then work with our clients to take action in order to combat FWA.

Fraud, waste, and abuse.

MedImpact’s integrated bundle of analytic and clinical services help empower plan sponsors to identify and combat fraud, waste, and abuse.

Analytics.

MedImpact’s Quality Performance Management Program (QPMP) delivers information from the population to the member level about adherence, treatment gaps and safety issues to help improve outcomes, CMS Star Ratings, and drug and medical spend.

Clinical outcomes.

We provide clinical expertise, national strategy, local customization, and personalized engagement programs to help improve member health.

ON A MISSION

Connected care.

Every year, we invest hundreds of millions of dollars in technology, people, and solutions to make healthcare benefits more connected, personal, and affordable.