Tackling healthcare fraud
Aiming to contain vast and fast-rising expenditure levels estimated to amount to 8.2% of GDP across OECD countries in 2003, national healthcare reforms cannot avoid rationing, that is withholding beneficial interventions from needy individuals. Yet, a substantial part of a nation’s healthcare spending is typically diverted in illicit ways–rendering otherwise feasible care unattainable and undermining the legitimacy of private and public services. In the US healthcare fraud and abuse reportedly accounts for around 10% of total outlays, i.e., $120 billion per year. In the UK prescription crime in 2003 was estimated to amount to £115 million. In Lower Saxony, one of Germany’s 16 Länder, insurance fraud alone accounted for €40 million in 2003. But cases are not always clear-cut and not always easily dealt with. There is often substantial ambiguity in defining what is actually improper conduct, identifying such behavior among vast numbers of cases that are handled annually, telling errors apart from criminal intent, and choosing adequate regulatory responses. This case can be used in conjunction with IMD-3-1464, IMD-3-1465, and IMD-3-1466.
2003/2004
Cranfield University
Wharley End Beds MK43 0JR, UK
Tel +44 (0)1234 750903
Email [email protected]
Harvard Business School Publishing
60 Harvard Way, Boston MA 02163, USA
Tel (800) 545-7685 Tel (617)-783-7600
Fax (617) 783-7666
Email [email protected]
NUCB Business School
1-3-1 Nishiki Naka
Nagoya Aichi, Japan 460-0003
Tel +81 52 20 38 111
Email [email protected]
IMD retains all proprietary interests in its case studies and notes. Without prior written permission, IMD cases and notes may not be reproduced, used, translated, included in books or other publications, distributed in any form or by any means, stored in a database or in other retrieval systems. For additional copyright information related to case studies, please contact Case Services.
Research Information & Knowledge Hub for additional information on IMD publications
There is a Chinese saying that wealth does not last beyond three generations, and the reality is that sustaining family businesses is a significant...
In this study, we examine the effect of cultural long-term orientation on the likelihood of adopting more family-intensive governance arrangements ...
Research Information & Knowledge Hub for additional information on IMD publications
Research Information & Knowledge Hub for additional information on IMD publications
in I by IMD 9 September 2024
Research Information & Knowledge Hub for additional information on IMD publications
Research Information & Knowledge Hub for additional information on IMD publications
in I by IMD
Research Information & Knowledge Hub for additional information on IMD publications
Research Information & Knowledge Hub for additional information on IMD publications
Research Information & Knowledge Hub for additional information on IMD publications
in I by IMD 2 August 2024
Research Information & Knowledge Hub for additional information on IMD publications
in Small Business Economics August 2024, vol. 63, pp. 731-754, https://doi.org/10.1007/s11187-024-00877-4
Research Information & Knowledge Hub for additional information on IMD publications
Research Information & Knowledge Hub for additional information on IMD publications