Recover payment dollars with key fraud, waste, and abuse algorithms
Manage data and insights
Government agencies working to have a meaningful impact on people's lives increasingly face questions around where to focus to improve services and lower costs.
With IBM Health and Human Services Analytics, you can augment existing data, resources and investments with new insights to assemble a more complete view of the populations you serve and deliver better outcomes.
“ People are frustrated with the paperwork. People are frustrated with the process. Everybody has their own idea of what’s possible because we have no standardized criteria. ”
— Tini Zainuden, Malaysian Child Activist
Track the health of high-risk populations
Public health crises, like COVID-19, highlight the escalating needs of at-risk populations –forcing further alignment of services and appropriate allocation of Federal funds and claims
Breadth of data
Draw from relevant health and social data, including administrative, pharmacy and clinical.
Access predefined services, including pre-built data models, to reduce time-to-value.
Augment your existing infrastructure for greater efficiency.
“ Knowing that we have really moved to a system that is really client centered is critically important. We are not making decisions for other people. We are allowing people to make their own decisions but providing the right resources without judgment, with dignity, and with as much support as possible. Those are the things that get me out of bed in the morning. ”
— Shana Overdorf, Homelessness Advocate
Iowa Medicaid Enterprise
Used specialized algorithms and predictive analytics to proactively identify everything from elaborate billing schemes to honest human errors, and recovered USD 19.2 million.
“ Often times, it can be easy to get focused on the measurement and the data, and the assessments that you’re doing. Sometimes the client or the patient care can get lost in there. So, you have to be really diligent to make sure you’re focusing on the person that’s in front of you and not just working through the paperwork or the documentation requirements. ”
— Nate Crowell, Licensed clinical social worker
Identifying and tracking those affected by COVID-19, and an appropriate resource funding
IBM’s HHS Analytics helps Medicaid and public health agencies to identify and track high-risk populations for both confirmed and potentially suspect cases, and makes sure government funds and resources go to fund the most effective programs.
Ready to optimize your benefits