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Dr. Eric Bricker discusses the importance of addressing fraud in employee health plans, citing estimates from Marshall Allen of ProPublica that suggest fraud could be as high as 10%. He emphasizes that reducing and eliminating fraud is essential for health plans because it does not necessitate changes in employee behavior, unlike many wellness initiatives. Additionally, addressing fraud does not require altering provider behaviors, which often involves complex issues such as over-utilization and unnecessary procedures. This focus on fraud presents an opportunity to improve health plan efficiency without relying on altering how employees or providers act.
