{"id":2944,"date":"2018-01-17T06:00:31","date_gmt":"2018-01-17T14:00:31","guid":{"rendered":""},"modified":"2023-05-31T16:40:15","modified_gmt":"2023-05-31T23:40:15","slug":"using-azure-to-fight-government-fraud-waste-and-abuse-part-1","status":"publish","type":"post","link":"https:\/\/www.microsoft.com\/en-us\/industry\/blog\/healthcare\/2018\/01\/17\/using-azure-to-fight-government-fraud-waste-and-abuse-part-1\/","title":{"rendered":"Using Azure to help governments fight fraud and waste\u2014Part 1"},"content":{"rendered":"<table border=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"middle\"><a href=\"hhttps:\/\/info.microsoft.com\/DigitalTransformationinHealth-Registration.html\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/www.microsoft.com\/en-us\/industry\/blog\/wp-content\/uploads\/2017\/01\/mag_icon_right_0078d7_40x39.png\" width=\"40\" height=\"39\" \/><\/a><\/td>\n<td valign=\"middle\"><a href=\"https:\/\/azure.microsoft.com\/en-us\/overview\/clouds\/government\/\" target=\"_blank\" rel=\"noopener\"><span>Learn more: Microsoft Azure Government<\/span><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-480324 alignleft\" src=\"https:\/\/www.microsoft.com\/en-us\/industry\/blog\/wp-content\/uploads\/2018\/01\/logo_main_pondera.png\" alt=\"\" width=\"205\" height=\"65\" \/>I always think the most fascinating stories on \u201c60 Minutes\u201d and other investigative programs are about government fraud, waste and abuse. That\u2019s why I\u2019m excited to have Microsoft partner <a href=\"http:\/\/ponderasolutions.com\/\" target=\"_blank\" rel=\"noopener\">Pondera Solutions<\/a> offering state-of-the-art, <a href=\"https:\/\/azure.microsoft.com\/en-us\/overview\/clouds\/government\/\" target=\"_blank\" rel=\"noopener\">Azure Government<\/a>-powered cloud computing solutions to fight this insidious problem. It was a pleasure to recently interview Pondera\u2019s founder and CEO <a href=\"http:\/\/ponderasolutions.com\/About\/ExecutiveTeam\/tabid\/125\/Default.aspx\" target=\"_blank\" rel=\"noopener\">Jon Coss<\/a> since his company pioneered many fraud, waste and abuse systems, which are now integrated with our secure, trusted Microsoft government cloud. Here\u2019s Part 1 of our two-part series:<\/p>\n<p><strong>Recently, government agencies have had a focus on fraud detection and management.\u00a0 What\u2019s the current state of fighting fraud, waste and abuse by government agencies?<\/strong><\/p>\n<p>Not that long ago, fraud, waste and abuse was a small subset of requirements in larger systems for tax, Medicaid and other programs \u2026 it was bundled in with all the other system functions, like paying claims and enrolling beneficiaries. Government has really started to shift away from that, which makes fundamental sense. You want the company and the system that\u2019s doing the actual processing of transactions to be separate from the company and the system that\u2019s (ensuring) the integrity of those transactions.<\/p>\n<p>We also hear from our clients and prospects, \u201cWe don\u2019t need anomalies that may not mean anything and are difficult to investigate; we need investigation-ready leads that our analysts and auditors can work on.\u201d We\u2019ve seen a move away from this focus on discrete transactions to looking at it more holistically\u2014looking for larger trends, patterns, clusters of suspicious activity \u2026 transactions over time.<\/p>\n<p>Two other significant things:<\/p>\n<ul>\n<li>We\u2019re seeing governments start to move toward more prepayment prevention vs. post-payment, pay-and-chase activities. The availability of cloud computing like we can do in Azure, gives us the ability to process massive amounts of transactions very quickly so that if we identify highly problematic claims prior to a payment being made, then it gives the government agencies the opportunity to not make that payment at all.<\/li>\n<li>We\u2019re also starting to see a really encouraging trend: within a state, agencies are starting to talk to each other. We\u2019re starting to see the first few bids come out \u2026 to address fraud, waste and abuse across agencies instead of within an individual agency. There\u2019s also a lot more discussion across states. The bad actors that are defrauding systems \u2026 they act across programs and in multiple states.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-480327\" src=\"https:\/\/www.microsoft.com\/en-us\/industry\/blog\/wp-content\/uploads\/2018\/01\/422_body.jpg\" alt=\"\" width=\"2000\" height=\"1333\" \/><\/p>\n<p><strong>Can you tell us more about Pondera Solutions and what government customers can expect to help them battle fraud, waste and abuse? <\/strong><\/p>\n<p>We offer a true software-as-a-service (SaaS) architecture, with a true multi-tenant environment to accommodate multiple programs within a state, same programs across states\u2014different combinations to really effectively fight fraud. This architecture also allows us to add new data sources as they become available and we can push new fraud detection algorithms as we develop them. If we find an emerging fraud scheme on the East Coast we could develop a fix for that in our algorithms and then deploy it to all of our customers.<\/p>\n<p>States are starting to look at fraud, waste and abuse more holistically \u2026 Last week, we just pulled in a transaction file from one of our larger clients and it\u2019s 750 million records\u2014 when you combine it with 20 to 30 external databases, that\u2019s a ton of data. We take all of that data\u2014we certainly provide alerts on individual anomalies, suspicious activities and suspected fraud\u2014but we pull it all together and we add it with our behavioral models and then we provide back a triaged list of cases. We uncover larger, more collusive activities and we provide a single fraud risk score \u2026 then we return back that investigation-ready lead that our clients are asking for\u2014and we do it quickly and we do it accurately. That\u2019s really what our clients can expect from us: rapid responses, very low false positive rates, triaged cases and, importantly, an understanding of a (larger) network that a case might be a part of.<\/p>\n<p><strong>Can you elaborate on why you decided to go with a SaaS approach?<\/strong><\/p>\n<p>What the cloud allowed us to do was take this massive computing power and advanced analytics and get really smart people to run this data &#8230; without having to build our own datacenter and with the ability to leverage Microsoft\u2019s security protocols. Without that, we never could have ever started this company \u2026 All we do is fraud, waste and abuse, and yet we can have as much computing power and as advanced analytics as any (traditional IT) company. Microsoft lets us be a fraud, waste and abuse company instead of a technology company; that\u2019s how I think Microsoft is changing the world. \u00a0<\/p>\n<hr \/>\n<p>There\u2019s a lot more to this story so please stay tuned for Part 2 on combating fraud, waste and abuse, including examples of positive customer outcomes. Until then, please:<\/p>\n<ul>\n<li><a href=\"https:\/\/info.microsoft.com\/governmentContactMe.html\" target=\"_blank\" rel=\"noopener\">Contact Microsoft<\/a> to find out how we or Pondera can bring an <a href=\"https:\/\/info.microsoft.com\/US-Azure-ContactMe-FY16-02Feb-12-AzureEverywhere_RegistrationPage.html\" target=\"_blank\" rel=\"noopener\">Azure planning session<\/a> onsite to your team.<\/li>\n<li>Discover why <a href=\"https:\/\/azure.microsoft.com\/en-us\/overview\/clouds\/government\/\" target=\"_blank\" rel=\"noopener\">Microsoft Azure Government<\/a> is the most trusted cloud for U.S. government agencies.<\/li>\n<li>Learn more at the <a href=\"http:\/\/ponderasolutions.com\/Blog\/tabid\/204\/Default.aspx\" target=\"_blank\" rel=\"noopener\">Pondera Fraudcast Blog<\/a>.<\/li>\n<li>Read Government Technology\u2019s recent article, \u201c<a href=\"http:\/\/www.govtech.com\/biz\/Pondera-Uses-Azure-in-Fraud-Detection-as-a-Service-Solution.html\" target=\"_blank\" rel=\"noopener\">Pondera Uses Azure in Fraud-Detection-as-a-Service Solution<\/a>.\u201d<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Pondera Solutions\u2019 state-of-the-art systems, powered by Microsoft Azure, are helping government agencies fight fraud, waste and abuse.<\/p>\n","protected":false},"author":0,"featured_media":10776,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ms_queue_id":[],"ep_exclude_from_search":false,"_classifai_error":"","_classifai_text_to_speech_error":"","footnotes":""},"categories":[1515,1507],"post_tag":[4291],"content-type":[1492],"coauthors":[950],"class_list":["post-2944","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-government","category-healthcare","tag-azure","content-type-news-and-announcements"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ 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