Related Experiment Video
Updated: Feb 11, 2026
15:01
Peering into the Dynamics of Social Interactions: Measuring Play Fighting in Rats
Published on: January 18, 2013
15.9K
Strategies for Fighting Medicare Fraud
Jamie McGee1, Leslie Sandridge, Cierra Treadway
1Author Affiliations: Lewis College of Business, Marshall University, South Charleston, West Virginia.
The Health Care Manager
|April 27, 2018
Summary
Medicare fraud costs billions annually. This study identifies fraud methods and evaluates US government programs designed to combat healthcare fraud, emphasizing the need for enhanced prevention strategies to control rising costs.
Area of Science:
- Health Economics
- Healthcare Fraud and Abuse
- Public Health Policy
Background:
- In 2014, US healthcare spending reached $3 trillion, with Medicare costs at $554 billion.
- Approximately $60 billion was lost due to Medicare fraud, including kickbacks, upcoding, and organized criminal activities.
- Rising healthcare expenditures necessitate robust fraud prevention measures.
Purpose of the Study:
- To identify prevalent methods of Medicare fraud.
- To examine government programs established to combat healthcare fraud and abuse.
- To assess the effectiveness of these fraud prevention initiatives.
Main Methods:
- Review of Medicare billing data and fraud typologies.
- Analysis of federal fraud prevention and enforcement programs.
- Evaluation of program outcomes and impact on healthcare costs.
Main Results:
- Identified key fraud schemes such as kickbacks and upcoding.
- Examined various federal initiatives aimed at mitigating Medicare fraud.
- Demonstrated the effectiveness of current fraud prevention strategies.
Conclusions:
- Current fraud prevention strategies have shown success in combating Medicare fraud.
- Continued enhancement and furtherance of these strategies are crucial.
- Increased fraud prevention and detection offer significant benefits in managing US healthcare expenditures.
Related Concept Videos
01:52Persuasion Strategies
43.5K
Researchers have tested many persuasion strategies, including the foot-in-the door and the door-in-the-face techniques, in a variety of contexts. Ultimately, the principles are effective in selling products and changing people’s attitude, ideas, and behaviors (Cialdini & Goldstein, 2004).
43.5K
01:27Coping Strategies: Problem Focused
529
Coping strategies are methods people use to manage, tolerate, or reduce the effects of stressors. These strategies involve both behavioral and psychological actions to handle stressful situations. One common approach is problem-focused coping, which aims to change or eliminate the source of stress rather than merely addressing its consequences. This method involves taking direct action to resolve the issue causing stress.
For example, consider a student who struggles to understand their...
For example, consider a student who struggles to understand their...
529
01:17Strategies of Self-Presentation II: Self-Verification
204
Self-verification is a fundamental psychological drive wherein individuals seek affirmation of their self-concept from others, striving for consistency between their internal self-view and external perceptions. This drive operates even when the self-concept is negative, influencing interpersonal behavior and feedback preferences in complex and often counterintuitive ways. Unlike the self-enhancement motive, which seeks positive evaluations, self-verification prioritizes coherence and...
204
01:20Coping Strategies: Emotion Focused
547
Emotion-focused coping refers to a set of strategies aimed at managing the emotional impact of stressors, rather than directly addressing their causes. This approach involves altering one's emotional response to stressful situations to reduce their psychological effects. For example, individuals might talk with a friend or engage in activities like journaling to express their feelings. Such actions can help achieve emotional clarity or release, providing the psychological stability needed...
547
01:18Guidelines and Strategies for Safe Computer Charting
2.7K
The guidelines and strategies provided by the American Nurses Association (ANA) and the Canadian Nurses Association (CNA) offer essential principles for ensuring safe and secure computer charting systems in healthcare settings. Let's break down each recommendation:
Maintain Confidentiality and Security:
Maintain Confidentiality and Security:
2.7K
01:12Strategies of Self-Presentation I: Strategic Self-Presentation
229
Strategic self-presentation refers to individuals' intentional efforts to influence how others perceive them. This process is employed in various social and professional settings, such as job interviews, dating, politics, and legal contexts, where individuals seek to shape impressions to gain social or material advantages. While people generally present themselves in ways that align with their authentic characteristics, external factors, such as cognitive load, can hinder their ability to...
229