Healthcare Data Sources and Fraud Research Opportunities

The healthcare industry in the United States comprises a significant portion of the U.S. economy; however, there is incidence and even expectation of pervasive fraud within this sector. Thus, research focused on understanding the determinants, detection, and consequences of fraudulent behavior in healthcare merit study. We highlight federal and state data sources of potential use for mostly archival fraud research. We acknowledge the existence of additional data sources beyond those described in our study, but we believe that the sources we highlight can provide an impetus for more healthcare fraud research. We also suggest some directions this research might take using the data available in these sources. There is an opportunity for accounting researchers to have a tangible impact on public policy in the healthcare sector of our economy due to the significant number of annual fraud cases and to answer questions in this unique setting that are generalizable to other industries