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Health care fraud and abuse enforcement: Relationship scrutiny

July 5, 2015 Comments off

Health care fraud and abuse enforcement: Relationship scrutiny
Source: Deloitte

Where is fraud and abuse enforcement headed in health care? One emerging area of interest is relationship scrutiny. Relationships can be complex in the business of health care: tracking and analyzing them is an important part of minimizing the fraud and abuse that may result from questionable relationships and improper influence.

Many organizations depend on analytics to understand their own performance. Insights and patterns within the data are often used to inform strategy and decision making. Researchers can apply analytics to identify external trends and factors that may impact businesses. To that end, Deloitte researchers used analytics techniques to examine the text of tens of thousands of federal regulations and identify emerging trends in health care fraud and abuse enforcement. The results are telling: Federal health care regulators are emphasizing relationship scrutiny in their fraud and abuse enforcement efforts. Also, discussion of health care fraud and abuse topics – including relationship scrutiny – is recurring, as evidenced by the cyclical rise and fall in frequency and relevance of keyword groups related to “enforcement,” “value-based care,” and “fraud and abuse.” The bottom line: discussion of these topics is present; relationship scrutiny is likely here to stay.

Minimizing the risk of health care fraud and abuse doesn’t have to be an impossible task. New insights can come from the application of analytics to an organization’s data sets. These insights, in turn, can be used to build a fraud and abuse risk-mitigation program.

This paper examines health care fraud and abuse enforcement drivers and laws, the cyclical trend of relationship scrutiny within the regulatory discussion, and how health care organizations can build a responsive, analytics-based program to address potential fraud and abuse. An effective program will likely enable organizations to identify risks in real time, adjust to mitigate them, communicate their importance, and learn from the regulatory and legislative landscape.

C-Level Executives, Including The Chro, Must Embrace Evidence-Based Hr Or Risk Facing Competitive Disadvantage: KPMG Report

July 2, 2015 Comments off

C-Level Executives, Including The Chro, Must Embrace Evidence-Based Hr Or Risk Facing Competitive Disadvantage: KPMG Report
Source: KPMG

A global survey titled Evidence-Based HR: The Bridge Between Your People and Delivering Business Strategy conducted by the Economist Intelligence Unit on behalf of KPMG International, the audit, tax and advisory firm revealed that while interest and investment in evidence-based HR is increasing, wide-spread adoption is still not getting the traction many predicted just a few years ago. Evidence-based HR uses data, research, and analysis to determine how HR practices affect business outcomes such as productivity, profitability, customer satisfaction and service quality.
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Top 10 Fastest Growing Canadian Industries

July 2, 2015 Comments off

Top 10 Fastest Growing Canadian Industries
Source: IBISWorld

The Canadian economy’s recovery from the recession has had wide-ranging impacts on domestic industries over the past five years. The ten fastest-growing industries over the past five years, measured by average growth in sales per year and compiled from IBISWorld’s 424 Canadian industry reports, feature industries from a variety of sectors, including heavy manufacturing, wholesaling and professional business services.

While each industry exhibited strong revenue growth, some have experienced cyclical growth while others have grown due to more secular trends. For example, the Nonferrous Metal Foundry Products Manufacturing industry has merely recovered from poor performance during the economic downturn and is unlikely to reach prerecessionary revenue levels. In contrast, up-and-coming industries, such as recycling facilities, have flourished due to longer-term shifts in consumer preferences. Similarly, industries such as fertilizer manufacturing have experienced wildly fluctuating demand, while others, such as the Beauty, Cosmetics and Fragrance Stores industry, have grown steadily over the five-year period.

Car Buyers Want Better Digital Experience, Most Ready to Complete Entire Process Online, Accenture Study Finds

July 2, 2015 Comments off

Car Buyers Want Better Digital Experience, Most Ready to Complete Entire Process Online, Accenture Study Finds
Source: Accenture

Most consumers are doing online research to help them make car-buying decisions, and most are doing so before visiting a dealership, a new survey by Accenture reveals. The survey also shows that 75 percent of drivers polled would consider conducting the entire car-buying process online.

The survey of 10,000 consumers in eight major countries found that 80 percent of drivers seeking to purchase a new vehicle are using some form of digital technology to research their buying preferences, and nearly two-thirds (62 percent) are initiating the car-buying process online, including consulting social media channels, before entering a dealership.

Additionally, three-quarters (75 percent) of the survey respondents said that if given the opportunity, they would consider making their entire car-buying process online, including financing, price negotiation, back office paperwork and home delivery. Two-thirds (69 percent) said they have either bought a car online or would consider doing so. The findings also reveal that consumers would be open to using new, emerging online channels for purchases. For example, 63 percent of respondents said they would be interested in buying a new car through an online auction.

2015 U.S. News/Raytheon STEM Index

July 1, 2015 Comments off

2015 U.S. News/Raytheon STEM Index
Source: U.S. News and Raytheon
From article:

While the number of jobs, types of degrees granted and level of student interest in the science, technology, engineering and mathematics fields continues to increase since 2000, the second-annual U.S. News/Raytheon STEM Index shows that mutli-million dollar efforts by both the public and the private sectors have failed to close gender and racial gaps in STEM.

The 2015 STEM Index, created with support from Raytheon, shows a slight uptick in STEM-related education and employment activity in the United States compared to last year. But the raw data show gaps between the men and women and between whites and minorities remain deeply entrenched — and, in some cases, have even widened.

With few exceptions, women lag behind men in the number of STEM degrees granted, exam scores and general interest in the STEM fields. White and Asian students and college graduates overwhelmingly outperformed black, Hispanic and American Indian students in all three metrics.

7 In 10 Insurers Unprepared For Potential Disruption Caused By Autonomous Vehicles: KPMG Survey

June 30, 2015 Comments off

7 In 10 Insurers Unprepared For Potential Disruption Caused By Autonomous Vehicles: KPMG Survey
Source: KPMG

Although the automotive and technology industries are moving swiftly to bring autonomous vehicles to market, the vast majority of insurers believe the potential impact is too distant in the future to begin preparing, according to the results of the Automobile Insurance in the Era of Autonomous Vehicles Survey conducted by KPMG LLP, the U.S. audit, tax and advisory services firm.

In surveying senior U.S. insurance executives whose companies, in aggregate, account for almost $85 billion in personal and commercial auto premium, KPMG found skepticism about the potential transformation autonomous vehicles will bring in the near-term. Few carriers have taken action—not due to doubts about the possible ramifications, but rather because most believe the change will happen far into the future, if at all. In fact, 84 percent of executives don’t expect autonomous vehicles to have a significant impact on their business until 2025, while 42 percent expect a significant impact in six to 10 years. Nearly three quarters of insurers (74 percent) feel they are unprepared for autonomous vehicles today. In addition, more than half of respondents (55 percent) believe that regulators will impede the adoption of autonomous vehicles, which may help to explain why they anticipate a more distant effect on their business.

Unlocking the potential of the Internet of Things

June 29, 2015 Comments off

Unlocking the potential of the Internet of Things
Source: McKinsey & Company

The Internet of Things—sensors and actuators connected by networks to computing systems—has received enormous attention over the past five years. A new McKinsey Global Institute report, The Internet of Things: Mapping the value beyond the hype, attempts to determine exactly how IoT technology can create real economic value. Our central finding is that the hype may actually understate the full potential—but that capturing it will require an understanding of where real value can be created and a successful effort to address a set of systems issues, including interoperability.

To get a broader view of the IoT’s potential benefits and challenges across the global economy, we analyzed more than 150 use cases, ranging from people whose devices monitor health and wellness to manufacturers that utilize sensors to optimize the maintenance of equipment and protect the safety of workers. Our bottom-up analysis for the applications we size estimates that the IoT has a total potential economic impact of $3.9 trillion to $11.1 trillion a year by 2025. At the top end, that level of value—including the consumer surplus—would be equivalent to about 11 percent of the world economy (exhibit).

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