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Perspectives

Mitigating fraud, waste, and abuse in health care

A five-minute read on mitigating fraud, waste, and abuse (FWA) in health care

With the overwhelming disruption brought about by COVID-19, things need to change. Ongoing, evolving waves of digital transformation are underway, empowering health plans and providers to root out FWA. This quick summary provides insights and actions providers can take today towards that goal.

Fraud, waste, and abuse

It’s no secret that health care is expensive. In 2018, US health care expenditures topped $3.6 trillion (or 17.7% of the Gross Domestic Product)1. And by 2027, US national health spending is projected to reach nearly $6 trillion2. It may come as a surprise that one study found that fraud, waste, and abuse (FWA) account for about 25% of the total cost of health care3.

5x5: Fraud, waste, and abuse

 

 

 

Endnotes

1 https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical

2 https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/ForecastSummary.pdf

3 https://mms.businesswire.com/media/20191007005615/en/748221/5/HHR.jpg?download=1

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