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WellPoint's Patrick McIntyre on anti-fraud analytics partnerships


FierceHealthPayer: Anti-Fraud spoke to Patrick McIntyre for expert advice on smart shopping for anti-fraud data analytics and how to work well with vendors. McIntyre (pictured) is senior vice president of healthcare analytics at Indianapolis-based WellPoint. For more than 25 years, he's led business operations, finance, analytics and information technology functions.

FierceHealthPayer: Anti-Fraud: With so many anti-fraud data solutions available, what criteria can insurers use to evaluate products and choose what's best for their business?

Patrick McIntyre: Know what your internal capabilities are and match those to the solution you need. Figure out if you have the internal resources to be able to do components of the overall solution implementation yourself.

For example, we were looking for a solution years ago since we didn't have the right internal expertise to build an anti-fraud analytic capability. So we looked for more of an out-of-the-box solution. If we were making that purchasing decision later, our needs would be different based on a new mix of employees with more advanced analytics expertise.

It's also important to determine if potential business partners have a proven record of delivering services they commit to. The last thing you want is to partner with a company that oversells capabilities you rely on and then find out they can't deliver on these when you reach the implementation stages.