Tarleton receives Blue Cross and Blue Shield grant to study fraud in health care claims

Tarleton State University and Blue Cross and Blue Shield (BCBSTX) of Texas are launching a research project around fraud detection in health care claims.

The project is part of efforts by BCBSTX to advance academic research to address the critical issues created by gaps and fragmentation that lead to a high-cost health care system, the university said in a news release March 1.

With a $1 million grant from BCBSTX, researchers in Tarleton’s Analytics Institute will study health care claims and develop novel methods to identify fraud using specialized systems and software.

“This public-private partnership brings value to Blue Cross and Blue Shield of Texas and to Tarleton,” said Dr. Barry Lambert, associate vice president of research and innovation. “Our students and researchers will provide expertise while gaining valuable experience and developing real-world solutions to reduce fraud and lower health care costs for Texans.”

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In addition to this project, BCBSTX is working with 10 other research institutions across the state to study a range of health care challenges, from behavioral health to improving vaccine adherence to expanding access to education for medical professionals. The projects will support the company’s objectives of addressing the root causes of an expensive health care system, the news release said.

“Failure to address access and affordability of health care has real consequences. We need to challenge the status quo by bringing transformative research and ideas to the table,” BCBSTX President Dan McCoy said in the announcement. “By collaborating with a diverse set of institutions and researchers who are embedded in and understand the communities we serve, we can better identify and develop solutions that tackle the high cost of health care at its foundation.”

Dr. McCoy presented the $1 million grant to Tarleton at the university’s annual gala earlier.

Projects at all 11 institutions are part of BCBSTX’s Affordability Cures SM endeavor and support initiatives in Texas and Illinois that help improve quality and coordination of care delivery, balance inequities and eliminate waste in the system.

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Other participating institutions are Baylor College of Medicine, McGovern Medical School at UTHealth in Houston, Rice University, Texas Tech University, University of Texas at Austin, University of Texas Dell Medical School, University of Texas Health Science Center at Tyler, University of Texas MD Anderson, University of Texas at Tyler and UT Southwestern Medical Center.

– FWBP Staff