AI In Focus: Targeting Fraud, Waste And Abuse In Healthcare

Report: 100 Healthcare Execs Speak Out On Using AI To Curb Fraud, Waste And Abuse Healthcare firms are losing 12 percent of their annual revenues to fraud, waste and abuse (FWA), yet few utilize artificial intelligence (AI) to address these issues due to cost concerns. In AI In Focus: Targeting Fraud, Waste And Abuse In Healthcare, a collaboration between PYMNTS and Brighterion, a Mastercard company, PYMNTS surveyed 100 healthcare executives to learn how AI could actually help firms unlock savings by curbing costly false claims and false positives.
Inside the July Playbook:
  • 92 percent: Portion of healthcare firms that say regulatory and compliance pressures are “very” or “extremely” important factors behind their decision to adopt AI
  • 86 percent: Portion of firms that use AI to detect claims payment-related fraud, waste and abuse that have developed their systems in-house
  • 68 percent: Share of firms that believe higher data management costs are the most important challenge when implementing AI tools to improve payment integrity

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