The IBM Risk Management Solution is the deployment of business services and data analytics to help social sector organizations develop methodologies to detect fraud and error, design techniques to combat the problem, match resource effort with program risk, and implement processes for solutions that the organization’s staff can operate on a sustainable basis.
The solution is a portfolio of complementary offerings that addresses four main issues:
- Healthcare provider fraud and abuse
- False identities and inadequate or false disclosure by citizens applying for benefits
- Not matching resource effort with benefit risk when making eligibility decisions
- Errors in citizen data repositories that may result in improper benefit payments
