STEPHENVILLE, Texas — Tarleton State University researcher Dr. Jesse Crawford will be recognized during the International Institute for Analytics’ ANNY Awards virtual ceremony at 11 a.m., Tuesday, Oct. 24.
Dr. Crawford and his graduate research assistant, Nicolas Petela, were nominated for healthcare analytics research, sponsored by Blue Cross and Blue Shield under the Affordability Cures Initiative.
“Improper health insurance payments resulting from fraud and upcoding result in tens of billions of dollars in excess health care costs annually in the United States, motivating machine learning researchers to build anomaly detection models for health insurance claims,” Dr. Crawford said in the project abstract.
The Tarleton team, working under the auspices of the Tarleton Analytics Institute, presented two strategies designed specifically for emergency room claims — an upcoding model based on severity code distributions stratified by hierarchical diagnosis code clusters, and a random forest model that minimizes improper payments by optimally sorting ER claims within review queues.
First awarded in 2012, the ANNY recognizes data teams that have made profound improvements in their organizations by applying advanced analytics to the most pressing business problems. Each year an International Institute for Analytics panel of independent judges narrows the long list of applicants to three finalists, with the winner announced at the ANNY Award Showcase.
The top 11 submissions, which include Dr. Crawford’s project, will be recognized at Tuesday’s event. Previous ANNY winners include Proctor & Gamble, Ford, Honeywell and, most recently, Echo Global Logistics.
For more information about the ANNY Awards virtual presentation visit iianalytics.com.
A founding member of The Texas A&M System, Tarleton State University is breaking records — in enrollment, research, scholarship, athletics, philanthropy and engagement — while transforming the lives of approximately 18,000 students in Stephenville, Fort Worth, Waco, Bryan and online. For 125 years, Tarleton State has been committed to accessible higher education opportunities for all while helping students grow academically, socially and professionally through programs that emphasize real world learning and address regional, state and national needs.