Strategies to Combat Waste in Healthcare: Tackling Inappropriate Billing and Inappropriate Care

In some European countries, apart from fraud, roughly one 5^th of the total healthcare spending is flushed away on unnecessary treatments and prescription drugs, redundant tests, errors , administrative inefficiency and myriad other monetary sinkholes that do nothing to improve public health.

According to  a recent report on this phenomenon by Thomson Reuters 700 billion $ or 30 % of the healthcare money is wasted in the US medical system every single year (an estimate of 175 billion $ fraud included).

This keynote will present strategies to tackle fraud and “waste” by demonstrating the effectiveness of 3 comprehensive actions : assessment or evaluation (prevention), information  or communication and finally control  or sanction (repression).

A representative selection of  risk exercises conducted in Belgium will show the importance of assessing the existence and the cost of waste (not only fraud and error) as well as the significance of analysing not only quantified and statistical evidence in order to detect incorrect billing but also to evaluate the purely medical aspects of the scope as to assess the cost of inappropriate care. The existence of  internationally accepted medical guidelines and legally valid extrapolation rules will be stressed as key factor for success.