Finding Excessive Treatment and Fraud Using Data Analysis

Now that a lot of Medicare information is public, it’s becoming easy to isolate cases of fraud and over treatment. Center for Health Reporting does just that. They found all the cities in California where there has been an excessive amount of certain types of procedures (such as angioplasty which is very expensive).

The following article on SF Gate discusses how Clearlake, California has an abnormal amount of angioplasties and angiographies and tries to find an explanation.

Normally you can explain an increase by the poorer and less healthy population that eats a lot of fried food. However, in this case, I believe it’s much simpler than that. All three cardiovascular disease doctors (that practice in Clearlake) went to the same school of medicine in Seoul. They either were taught wrong or they have been friends for a long time and consprired to get more procedure referral fees to supplement their incomes.

This is a great example of data mining helping bring down healthcare costs.

This entry was posted in Doctor Patient Relationship, Health Insurance, Healthcare Politics, Price Transparency. Bookmark the permalink.

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