GovLoop’s latest report, Unlocking the Power of Government Analytics, provides an overview of government analytics, identifies leading case studies, and integrates the results of a recent GovLoop survey from 280 members of the GovLoop community.
Check out more information here:http://www.govloop.com/profiles/blogs/new-govloop-report-unlocking-the-power-of-government-analytics
2. THEGOVLOOPGUIDE 3.
2. GOVERNMENTANALYTICS
WELCOME CONTENTS
About GovLoop - - - - - - - - - - - - - - - - - - - - - - - - - - - 4 Ten Steps to Leveraging Analytics in the Public Sector - - - - - - - - - - - - 29
1. Collaborate with peers and work across silos to share data and resources
2. Strong leadership needed
Executive Summary - - - - - - - - - - - - - - - - - - - - - - 5 3. Clear vision of how to use analytics to solve a problem
Are you using analytics in your agency? 4. Identify the right data
Unlocking the Power of Government Analytics 5. Address challenges for implementation
6. Assess workforce and build analytics support team
Expert Insights: Three Steps to Implement Analytics - - - - - - - - - - - 7 7. Pilot – start small and build quick wins
8. Choose the proper reporting techniques
9. Map to strategic needs at agency
Overview of Government Analytics - - - - - - - - - - - - - - - - - - 11 10. Understand any cultural shifts that may take place
What are the benefits of analytics in government?
What are some of the challenges for government analytics?
Volume of data 5 Questions to Ask for Analytics Initiatives - - - - - - - - - - - - - - - - 35
Variety
Velocity Final Thoughts & Acknowledgements - - - - - - - - - - - - - - - - - - - 38
Identifying value
GovLoop Resources - - - - - - - - - - - - - - - - - - - - - - - - - - 39
Data Driven Decisions: How Analytics Transforms Services - - - - - - - - - 17
A case study from Evanston Public Library
Increasing Transparency Initiatives Through Analytics - - - - - - - - - - 21
A case study from Maryland StateStat
5 Lessons Learned from Maryland State Stat Case Study
Fighting Waste, Fraud and Abuse through Analytics - - - - - - - - - - - - 25
A case study from Centers for Medicare & Medicaid Services (CMS)
3. THEGOVLOOPGUIDE 5.
4. GOVERNMENTANALYTICS
ABOUT GOVLOOP EXECUTIVE SUMMARY
Location
GovLoop is headquartered in Washington D.C GovLoop’s report, Unlocking the Power of Gov- data infrastructure to support improved deci-
with a team of dedicated professionals who ernment Analytics, will provide an overview sion-making through analytics.
share a commitment to connect and improve
government.
of government analytics, identify leading case
studies, and integrate the results of a recent In a survey of the GovLoop community, par-
GovLoop GovLoop survey from 280 members of the ticipants were asked if they are using analyt-
734 15th St NW, Suite 500 GovLoop community. Further, this report will ics in their agency. Overwhelmingly, agencies
Washington, DC 20005 provide ten steps to leverage analytics within reported they are indeed using analytics in
Phone: (202) 407-7421 a government agency. This report includes ex- some capacity. In the survey, 57 percent of re-
Fax: (202) 407-7501 pert interviews from: spondents stated, “Yes - but a very basic lev-
el,” 12 percent stated that they rely on robust
John Landwehr, Vice President of Digital Government analytics, 12 percent also stated they are cur-
Solutions, Adobe rently exploring how to best use analytics, and
Nils Engel, Solutions Engineer, Adobe 19 percent stated they are not using analyt-
Karen Danczak-Lyons, Library Director, City of ics yet, but would like to learn more. From our
Evanston survey, it is clear that agencies understand the
Beth Blauer, former Maryland StateStat Director power of government analytics, and that there
Staff Members, Centers for Medicaid and Medicare is enormous potential in using analytics to re-
Services duce costs, increase efficiencies and improve
service delivery.
The case studies highlighted in this report iden-
tify strategies for agencies to identify cost sav- At GovLoop, our mission is to “connect govern-
ing measures, improve performance and effi- ment to improve government.” Consistent with
ciency, and develop new strategies to enhance our mission, this report provides improved
customer service through analytics. Undoubt- awareness to the power of government analyt-
edly, analytics is transforming the way govern- ics to help transform and modernize govern-
ment operates and delivers services to custom- ment agencies. With any questions about this
GovLoop’s mission is to connect government to day, GovLoop is the leading site for addressing ers. At all levels of government, agencies are report, please reach out to Pat Fiorenza, Senior
improve government. We aim to inspire public public sector issues. now challenged to reduce costs, improve effi- Research Analyst, GovLoop.
sector professionals by acting as the knowl- ciency, and implement innovative measures to
edge network for government. The GovLoop GovLoop works with top industry partners to meet the complex needs of an agency.
community has over 60,000 members work- provide resources and tools to the government Not Yet - 19%
ing to foster collaboration, solve problems and community. GovLoop has developed a variety On a day-to-day basis, government agencies 12% 12% but would like to learn more
share resources across government. of guides, infographics, online training and collect, create, store and manage large vol- Currently Exploring - 12%
educational events, all to help public sector umes of data. Whether the data is from trans- 19% how to best leverage analytics
The GovLoop community has been widely professionals become more efficient Civil Ser- actions online, visits to web pages, interactions Yes - 57%
recognized across multiple sectors. GovLoop vants. on social media, government agencies are cre- 57%
but at a very basic level
members come from across the public sector. ating enormous volumes of data daily. Like- Yes - 12%
Our membership includes federal, state, and GovLoop’s 2012 Technology in Review Report wise, the data collected is either in structured we rely on robust analytics to meet agency goals
local public servants, industry experts and pro- is sponsored by Cisco, Google, GovDelivery, HP, and unstructured formats, which makes ex-
fessionals grounded in academic research. To- IBM, Oracle and Microsoft. tracting knowledge a challenge. In some cases,
decision makers do not have access or the right Are you using analytics in your agency?
4. THEGOVLOOPGUIDE 7.
6. GOVERNMENTANALYTICS
Unlocking the Power of
Government Analytics
Expert Insights: Three Steps to
Implement Analytics
In an environment where agencies are looking based as well as behind your firewall. So we can
to streamline activities, maximize efficiency provide anything from standard web reporting,
and significantly decrease waste, fraud and what people are doing on your website, how
abuse, a comprehensive analytics solution they get there, are they able to get to the end
should be considered by government agencies. goal of the website, and all the way to very ad-
vanced analytics on the web data. Adobe can
John Landwehr, Vice President of Digital Gov- also see if people are trying to hack into your
ernment Solutions and Nils Engel, Solutions website, or doing things that they shouldn’t be
Engineer of Adobe provides expert insights on your website, and then are able to under-
how to implement an analytics program in the stand specifically where those attacks are com-
public sector. ing from.”
With the volume, variety, and velocity in which To address the need to serve agencies with
data is collected by government agencies, both low and high security requirements, Ado-
analytics software helps “organizations better be has created differing programs to provide
manage their systems by measuring the effi- varying levels of services to a myriad of clients.
ciency, usage, trends, interactions, and the cor- These programs can exist on the cloud or be-
relations of people, places, and things within hind a firewall. Such software can serve both
their organization,” states Nils Engel, Solutions small companies that are curious about the
Engineer at Adobe in a recent interview with success of an application, or agencies in the in-
GovLoop. telligence community that desire to use com-
plicated analytics but need tighter security.
In our interview, Landwehr, described a few of
the activities Adobe’s software completes for The variety of activities that analytics software
its clients: can complete ranges from complicated security
analysis to simple data interpretation. Through
“Adobe provides solutions that are both cloud- analytics, programs can measure the potential
6. THEGOVLOOPGUIDE 11.
10. GOVERNMENTANALYTICS
Overview of Government
Analytics
With the explosion of data in the public sector, tive analysis, explanatory and predictive mod-
government agencies are now challenged to els, and fact-based management to drive deci-
identify ways to unlock the power of govern- sions and actions.” (i)
ment analytics. Agencies are exploring ways
to manage and store large volumes of data In many cases, analytics has improved ser-
collected on a day-to-day basis. Whether it in- vices, increased transparency, and provided
volves transactions online, visits to web pages, increased accountability to government pro-
or interactions on social media, government grams. Wazlawik continues:
agencies are creating enormous volumes of
data daily. “Given the reality of budget constraints and a
seemingly endless supply of data, the advan-
Ami Wazlawik, a former GovLoop Research Fel- tages of using analytics are clear. A fully de-
low, writes on GovLoop that analytics is “the veloped analytics system, however, does not
extensive use of data, statistical and quantita- simply appear overnight. Agencies need mon-
7. 10
THEGOVLOOPGUIDE 13.
12. Government GOVERNMENTANALYTICS
Case Studies & ey, staff, appropriate data and said one GovLoop survey par-
Analytics Resources technology, supportive lead-
What Are the Benefits of Analytics in Government? ticipant.
ership, and a goal or target, to
really make the best use of an- One of the core challenges for
alytics. Leaders need to work Improved Efficiency and Productivity 85% government employees is un-
to integrate analytics into the derstanding the sheer num-
work and culture of their re- ber of data points that are
1. HowTo.Gov: Digital Metrics for Federal
spective agencies, and need
to encourage cooperation be-
Drives improved decision making 78% created by the agency. In a
recent white paper, Accelerat-
Agencies tween agencies and partner- ing Government Intelligence to
ships with outside organiza- the Speed of Thought, Adobe
tions, when needed.” Manages Resources/budgets and control costs 68% writes:
2. CDC eHealth Metrics Dashboard Wazlawik could not be more “The sheer magnitude of the
accurate in her assessment. Transparency and Accountability 68% data that needs to be combed
is staggering. In today’s digital
3. EPA Site Statistics To further reinforce Wazlawik’s world, individuals, corpora-
observation and to ground it tions, organizations, and gov-
in feedback from the GovLoop Control Waste, fraud and abuse 46% ernments all generate huge
4. USDA Page-Tagging Metrics Strategy community, consider some of volumes of data. Every phone
the results from a survey Gov- call, credit card transaction,
Loop conducted on analytics, and visit to a website creates
which elicited 280 responses. as the core benefit of analytics emerged from participant re- a data point that is collected
5. City of Boston In that survey, participants (68 percent). Respondents also sponses to the GovLoop sur- and stored in a different sys-
were asked to define the ben- stated other benefits of analyt- vey. The challenges were the tem. This translates to massive
efits of analytics. The results of ics, such as: volume, variety, velocity, datasets for analysts to access
6. U.S GAO Cost Effectiveness Evaluation two questions from the survey value of the data collected. and manipulate.”
can be found below. “Find the story lines you want These findings are consistent
to tell. See if data will speak to with current trends around big As this report has already indi-
7. Web Metrics Among CENDI Agencies What are the benefits of that,” data, analytics and data use in cated, the challenge for gov-
analytics in government? the federal government. Our ernment employees is how to
“Analytics helps tell the story of findings reinforce the need for best map data to solve organi-
Survey participants were why investments in website are improved education on how zational challenges. With large
8. Los Angeles County Child Care Fraud asked to define the benefits important. Their use helps de- agencies can best leverage volumes of data, it is impera-
of adopting an analytics initia- fine ROI and makes a case for data and analytics within their tive that agencies identify the
tive. Participants could select web investments,” agency. right data to solve the prob-
9. Washington DC Fire Hydrant Tracking all answers that applied from lem they have addressed.
and Assessment among transparency and ac- “Decisions made from numeri- Volume
countability; improved effi- cal data rather than gut feel,” Variety
ciency and productivity; con- and, The biggest challenge with
trol waste, fraud and abuse; government analytics is the A second challenge is that data
10. North Carolina Dept. of Health and manages resources, budgets “Better allocation of human re- ”associated costs and time re- comes in a variety of forms,
and controls costs; and drives sources - time, energy, talent.” quired to make the right de- and standardizing informa-
Human Services Fraud Detection improved decision-making. cisions on what, when, who, tion can potentially be a large
Respondents selected “drives On the other hand, four chal- how, in regards to collecting, undertaking for government
improved decision-making,” lenges for analytics also managing and using the data,” agencies. The Adobe report
(i) Davenport, T. H., & Jarvenpaa, S. L. (2008). The Strategic Use of
Analytics in Government. Page 58.
8. THEGOVLOOPGUIDE 15.
14. GOVERNMENTANALYTICS
further states: and so forth. Lastly, unstruc- challenge also involves work- tion, benchmarking is difficult
tured data is constantly be- ing collaboratively across an when exceptions are made for
“Data is in a multitude of dispa- ing generated such as blogs, agency to provide access to every 1 special case.”
rate data types. Transactional comments on articles, discus- data that will be critical to the
data that provides information sion forums, email, and other analytics program. Velocity
about events, such as credit socially driven communication
card purchases, the details of and commentary. Combining One respondent to the Gov- Data can change the minute
a cell phone call, or an airline these disparate data types into Loop survey confirmed this or second it is captured. With
flight booking. There is also one common environment for challenge, indicating that the speed at which data is col-
streaming data, or a continu- analysis is a daunting task.” one of her top hurdles was, lected and moves, an analyst
ous flow of log-type informa- “Data entered multiple times is challenged to keep up with
tion that follows movement, Although this is a daunting in multiple places. Also, data rapidly-changing data sets.
such as a web log that streams task for government agen- validation is a huge issue as This is where an analytics solu-
information on what a user is cies, standardizing this data is culture that lives and dies tion can be imperative to the
doing—every page visited, ev- is imperative to leverage gov- by complicated and com- success of an analytics pro-
ery click, every item viewed, ernment analytics. Part of the plex spreadsheets. In addi- gram, as an analytics solution
can be seamlessly integrated
to the decision making pro-
cess to track data and make
data-based decisions.
What are some challenges of government analytics? Value
For government agencies, one
Various Types of Data collected
63%
constant challenge is identi-
fying what data is high value,
Difficult to find Relationships and what data may just be
clutter. One survey respon-
dent described this challenge
as, “Parsing data to determine
Access to Information
56%
what applies to my program
versus the overall agency.”
Does not have access to right data Some data might be more
valuable than other data for
addressing challenges within
an agency. For government
Storing and managing large
42%
leaders, they need to clearly
articulate which information
volumes of data will allow them to make the
soundest data-based decision.
speed at which data is created
hard to make sense of volume 38%
9. THEGOVLOOPGUIDE 17.
16. GOVERNMENTANALYTICS
Data Driven Decisions:
How Analytics
Transforms Services
A case study from Evanston
Public Library
Public libraries continue to be an important GovLoop recently spoke with Karen Danczak-
gathering place for communities. Libraries Lyons, Library Director of the Evanston, Illinois,
serve as meeting locations, provide access to Public Library. The interview highlights how
the Internet, and function as a knowledge hub the City of Evanston Library has used data to
for people to research information. transform library services, and update systems
to keep pace with service demands from pa-
Libraries across the country are undergoing a trons. Danczak-Lyons states, “Traditionally, es-
transformation in how services are delivered, pecially at public libraries, we have looked at
and libraries are rapidly changing their service circulation as indicators of usage, but we are
delivery models. As people have become in- really broadening as our service delivery mod-
creasingly reliant on technology, libraries have els have changed.”
been adapting to the new ways people con-
sume information. In order to keep the pace of Many of the changes Danczak-Lyons highlights
technology advancements, many public librar- in the interview were also reflected in a re-
ies are using analytics, and using data to mod- cent Pew study published in January of 2013,
ernize services and offerings to patrons. Library Services in the Digital Age. The study
10. THEGOVLOOPGUIDE 19.
18. GOVERNMENTANALYTICS
rint is shrinking
and trending tinue to provide traditional that the library tracks informa-
library resources. The Pew Re- tion around desktop comput-
more towards online data- port states, “The availability of ers. The library looks at wait
free computers and internet time and demand for public
bases and websites, so we access now rivals book lend- access to a computer. Know-
are looking at usage pat- ing and reference expertise ing this information, staff can
as a vital service of libraries. decide what kind of invest-
terns, which help guide Further, the report finds that ments to make for internet
77 percent of people say free use, whether that is decisions
investment decisions.” access to computers is a “very around installing new comput-
important” service provided ers or providing more band- data, desktop computers, re-
Karen Danczak-Lyons, by libraries. width for internet access. “We search databases, all have
Library Director, Evanston, Illinois, track not only internet sessions been made due to advanced
Public Library
In Evanston, as is true across used, but the demand and wait knowledge of how patrons are
the country, the public library time for computers guides us accessing information. “Our
shows how library patrons is one of the only spots people into decisions of where and patrons have their own devic-
desire an expansion of digital can receive free internet ac- what kind of computers to in- es, not necessarily a computer,
services, and continuation of cess. Danczak-Lyons states: stall,” states Danczak-Lyons. maybe a tablet or smartphone
print services. Danczak-Lyons they want to use to access the
expressed a very similar senti- “For many parts of our patron 3 Lessons Learned from internet, so we use this data to
ment as the Pew study, stating: base, we are the only internet Evanston Public Library programming forward,” states ing. Analytics is essential to know if we need to invest in
access they have. With so many Danczak-Lyons. this process, and knowing that more bandwidth for internet,”
“Print is shrinking and trend- people losing their jobs, and The Evanston public library is a decision is grounded in data states Danczak-Lyons.
ing more towards online da- can no longer use the internet an excellent case study as to No matter how large or small can help decision makers ar-
tabases and websites, so we through work, or they can no how using analytics and data the decision, clarity when mak- rive at a difficult and challeng- 3. Set Success Met-
are looking at usage patterns, longer afford it at home, we can help improve decision- ing a decision is essential. This ing decision. rics
which help guide investment are creating the second digi- making. The conversation with does not mean that decisions
decisions. Not that we will ever tal divide, so people that have Danczak-Lyons offered many are made in a robotic fashion. 2. Use Data to Define Critical to the success of a pro-
get rid of print resources, but used the internet and value it, best practices, lessons learned In fact, the calmness and clar- Customer Needs and gram is setting performance
depending on the quality and but no longer can afford it are and tips for those invested in ity of a leader while making Demands metrics and understanding
depth of the resources of the now returning to public librar- an analytics program. Below decisions shows the ability to how success is defined for an
database, that’s something we ies more and more.” you will find the top three les- manage emotions, and ratio- “You need to be clear how you organization. As Lyons states,
look at strategically and shift sons learned from the Evan- nalize each decision. It’s an im- are defining and collecting “Identifying at the front end
our resources more and more Other data that Evanston Pub- ston Public Library. perative skill for leaders, who these data points, and what of what you’re going to mea-
into that area.” lic Library collects includes are constantly learning how is brought into an analysis sure and how, and trying to
internet use data, foot traffic, 1. Take Emotion Out to manage emotions, in order to reach a conclusion,” states describe what success looks
Clearly, libraries are transition- database use, and website an- of Decision Making to make the right decision for Danczak-Lyons. like, so you know what success
ing how services are delivered. alytics. All of this data is used their organizations. When ar- looks like when you see it.” This
Much of the transformation is to improve the quality, and “Analytics helps take emotion ticulating a position and ex- At the Evanston Public Library, process is essential for manag-
due to how the internet has kinds of services that are col- out of the decision making. plaining a decision, it’s not just clearly data has been collected ers. By defining success, agen-
dramatically changed how lected. When resources are scarce or taking into consideration hard and used to make informed cies can set benchmarks, mea-
people access information. As limited and the need is great, facts; it’s acknowledging and decisions about how to best sure against past performance,
libraries adjust their services, An analytics example that finding a fact based way to empathizing with the very hu- use data to improve services. and identify new methods to
they are challenged to con- Danczak-Lyons identifies is make decisions can help move man element of decision mak- Decisions around wireless improve services.
11. THEGOVLOOPGUIDE 21.
20. GOVERNMENTANALYTICS
Increasing Transparency
Initiatives Through
Analytics
A case study from Maryland
StateStat
Transparency is cited by public and private had a high murder rate, poverty was rampant
agencies as one of the major benefits of using and trash lined the streets. Local federal em-
analytics. While companies in the public and ployees would be absent at work and neces-
private sectors may ultimately have differing sary tasks would go unfinished. New York City,
goals, their use of data to improve transpar- which had experienced these problems a de-
ency can be very similar. Transparency can be cade earlier, was now using a program called
described as providing the public with large CitiStat to collect data and then analyze it to
amounts of data about a company or agency in learn more about the crime and other issues
order to represent its activities. This informa- that plagued the city in search of remedies.
tion can reflect spending, and potentially gain O’Malley decided to replicate New York CitiStat
support and trust from the public. It can also to address similar challenges in Baltimore.
benefit the agencies themselves. Maryland
StateStat has harnessed the power of analytics O’Malley wanted to run government like a
to transform Baltimore. business in the sense that government agen-
cies would have a more concrete awareness
In the late nineties, Martin O’Malley came to of- of assets and functions. For example, O’Malley
fice as mayor of Baltimore. At the time the city wanted to be able to know how many trash
12. THEGOVLOOPGUIDE 23.
22. GOVERNMENTANALYTICS
removal trucks Baltimore had 5 Lessons Learned Mary- stituents can understand their maintained by the Federal
and where they were sched- land State Stat capabilities and limitations of Government is a national as-
uled to pick-up, so if trash was an agency and then created set.”
left on the side of the road, 1. Know Your Agency expectations and goals.
there was a clear path to hold- Maryland StateStat, according
ing someone accountable. On Blauer identifies, “getting your Blauer states, “The use of data to Blauer, “was not designed
a larger scale, the Mayor want- data all in one place provides and analytics from a baseline as a transparency initiative;
ed to cut down violent crimes an enormous opportunity to perspective helps agencies we were a performance man-
and to work on sustainability baseline and figure out where create more realistic strategic agement initiative.” The goal
projects, all of which he cur- you are.” Analytics provides goals, and strategic planning initially was to improve pro-
rently accomplished or is on the opportunity for an agency in government helps you con- ductivity; however, by using
track to accomplish. O’Malley to look at itself more objec- textualize what you’re trying analytics State Stat learned
was able to succeed because tively. Through analytics ini- to do.” In the end, both the how to collaborate and com-
of the transparency that came tiatives, agencies can reveal agency and the public will be municate with all of their part-
from using analytics. This has places where spending needs more satisfied with project ners to provide a more trans-
since been used for the col- to decrease, how to improve outcomes. parent work process.
lecting and analyzing data for communication across an or-
the rest of the state of Mary- 3. Hold People Ac- Through Blauer’s interview, we and the public may still not determine what data it already
ganization and clearly define
land. countable and Recog- have learned about the ben- understand its benefits. If an has and what type of informa-
the quality of the services the
nize the Importance efits that come from harness- agency makes data and the tion will be needed, thus creat-
agency provides.
To get more insight on the of Leadership ing data and using it to benefit results of the analytics avail- ing a baseline.
effects of analytics and the the functions of a local gov- able then this transparency
2. Have Realistic
benefits of transparency in Accountability also lies at ernment agency. As one of the will allow the public to see the Blauer points out that “base
Goals
the public sector, GovLoop the heart of the desire for in- first states to widely use ana- agency’s analytics program lining helps you strategically
interviewed Blauer, a former creased transparency. Presi- lytics, Maryland StateStat has value. On the Maryland State- figure out where you want to
Before analytics, government
employee at Maryland State dent Obama stated, “Transpar- shown the value of increased Stat website, there is a section be, so you can start building
agencies had to rely on anec-
Stat. According to Beth Blauer, ency promotes accountability transparency. called “Open Data Portal” that your goals and not make de-
dotal evidence, limited data
there are three major advan- and provides information for provides statistics from every- cisions based on anecdotes
and the desires of leaders. With
tages to using analytics to cre- citizens about what their gov- Blauer described leadership as thing from number of arrests or not based on evidence.”
data being widely available,
ated transparency of local gov- ernment is doing. Information the most important step in any to greenhouse gas emissions. The data needs to be verified
agencies employees and con-
ernment. analytics initiative. “Leadership By providing this information, so that decisions are concrete
is the first thing,” She said, “you citizens can know the state of and can be understood by em-
need to have a cheerleader.” their city and the efforts that ployees and the public. In the
Leadership provides legitima- their local government is mak- beginning, says Blauer, many
cy in the efforts of government ing to improve their commu- employees and constituents
employees. If a visible leader nity. may question the validity of
spearheads or supports an ini- the data but “when you have
tiative, then other employees 5. Collect Right Data an analytics tool that is con-
and constituents will be more and Develop Baselines stantly utilizing the data, over
likely to support and trust the time your data is evolving. We
program. When it comes to analytics, were constantly testing the
data is the most important as- data and comparing it to other
4. Show a Clear Busi- pect. This data needs to be in- data, making sure we under-
ness Value formation that will support the stood the data very well. We
efforts of an agency. To deter- saw the quality increase over
Though analytics adoption is mine the type of data an agen- time.”
increasing, local governments cy needs, the agency needs to
13. THEGOVLOOPGUIDE 25.
24. GOVERNMENTANALYTICS
Fighting Waste, Fraud
and Abuse through
Analytics
A case study from Centers for Medicare
& Medicaid Services (CMS)
GovLoop recently had the opportunity to speak ed a thorough analysis of the Fraud Prevention
with staff members from the Centers for Medi- System (FPS) in a recent report to Congress.
care and Medicaid Services (CMS). CMS staff
provided expert insights on the importance of The FPS was required under the Small Business
analytics to control waste, fraud and abuse. In Jobs Act of 2010 (SBJA). In the report to Con-
2010, CMS and the Department of Health and gress, CMS staff states:
Human Services (HHS) launched an aggressive
campaign to reduce fraud for medical claims. “Since June 30, 2011, the FPS has run predic-
tive algorithms and other sophisticated ana-
To meet their goals of reducing fraud, CMS de- lytics nationwide against all Medicare fee-for-
veloped a new anti-fraud tool using predictive service (FFS) claims prior to payment. For the
analytics and real-time data to spot abnormali- first time in the history of the program, CMS
ties for fee-for-service claims. CMS has provid- is systematically applying advanced analytics
14. THEGOVLOOPGUIDE 27.
26. GOVERNMENTANALYTICS
against Medicare FFS claims
on a streaming, nationwide
basis.” he ability to link providers
The SBJA identifies specific through their social networks
functional requirements of the
predictive analytics technolo-
gies for CMS. This report iden- helps CMS and its law enforcement partners
tifies the following require-
ments for CMS: unravel the complex relationships among
Provide a comprehen-
sive view of Medicare FFS fraudulent providers and between providers
provider and beneficiary
activities to identify and and beneficiaries.”
analyze provider networks,
billing patterns, and ben-
Staff Members, CMS
eficiary utilization patterns Report to Congress
and identify and detect
patterns that represent a
high risk of fraudulent ac-
tivity
Integrate fully with the
Medicare FFS claims flow
tem, CMS worked across sec- Anomaly Detection Models period, the FPS can alert an in- tion; whereas independently, behavior. This process allows
Analyze large datasets for
tors to learn best practices vestigator to inspect the claim those factors may not be sus- them to understand trends,
unusual or suspicious pat-
from the telecommunications The first model that is used by prior to payment.” picious.” and since information is occur-
terns or anomalies before
and banking industry. CMS is the anomaly detection ring in real-time, FPS is able to
payment and prioritize
model, which is a sophisticat- Predictive Analytics Social Network Analysis immediately spot fraud, saving
suspicious activity
The report to Congress iden- ed model that defines thresh- the time of investigators and
tifies three analytic strategies olds of acceptable behavior. CMS has also developed rigor- Social network analysis mod- CMS staff.
Capture outcome informa-
that CMS has implemented: This model compares an indi- ous predictive analytics mod- els are also used by CMS to
tion to continually refine
anomaly detection models, vidual providers behavior pat- els to spot and identify fraud- identify links to fraudulent CMS staff mentioned that for
and enhance the system
predictive models, and social terns and contrasts with that ulent claims. This model uses complaints. “The ability to link those getting started with an-
network analysis. of a peer group. The report data collected from previous providers through their so- alytics, it is essential to clearly
Prevent payment of fraud-
states, fraud cases to help predict fu- cial networks helps CMS and define the problem that is be-
ulent claims.
In our interview, CMS staff ture instances of fraud while its law enforcement partners ing solved, be sure the right
identified that through robust “Certain behaviors and charac- allowing CMS to investigate unravel the complex relation- data is collected, and identify
The Fraud Prevention System
analytics adoption, the agency teristics that indicate potential suspicious complaints. The ships among fraudulent pro- resource needs for an analytics
(FPS) developed by CMS uses
is able to improve the alloca- fraud may also be indications CMS report states, “Develop- viders and between providers project.
predictive analytics technol-
tion of investigative resources of acceptable behavior. For ing predictive models requires and beneficiaries,” states CMS.
ogy to identify and prevent
and become more efficient example, if a provider bills for advanced analysis because a
medical fee-for-service (FFS)
identifying and finding fraud- many more services than are fraudulent claim may become The FPS has saved CMS millions
claims. Since June 2011, CMS
ulent claims. normally performed by simi- apparent only when factors of dollars, and allowed CMS to
has been using FPS to screen
lar providers in a defined time are considered in combina- identify claims and patterns of
FFS claims. To build the sys-
15. THEGOVLOOPGUIDE 29.
28. GOVERNMENTANALYTICS
Ten Steps to Leveraging
Analytics in the
Public Sector
Whether you are looking to implement predic-
tive analytics, or to use your web data in a more Collaboration is also essential for analytics
compelling way, this report highlighted com- adoption. Agencies will have to work collab-
mon challenges, case studies, and strategies to oratively across departments to share informa-
get you started. This report concludes with ten tion and resources. This will also build trust,
steps to truly leverage analytics in the public improve communications and help to develop
sector. a culture of analytics across the agency.
1. share data and resources 2. Find strong leadership
There is enormous value in finding and talking Leadership needs to be in support of the ana-
to people with similar challenges and have al- lytics program, provide adequate resources
ready worked through challenges while adopt- and clearly chart a course for an analytics ini-
ing analytics programs. Peers within an agency tiative within the agency. Without leadership,
can serve as an imperative resource for the suc- analytics initiatives will not be able to fully le-
cess of any analytics program. verage all the potential of making data driven
16. THEGOVLOOPGUIDE 31.
30. GOVERNMENTANALYTICS
ics is still emerging within the cess with broader analytics
Start by understanding what public sector, and although adoption. By starting small,
data is needed to solve the there is a clear value for analyt- many challenges can be ad-
problem, and know where to ics, it can be faced with resis- dressed with more attention,
access, share and store this tance. Like any new initiative and can ease implementation
information. This process is that is disruptive to an agency, efforts as the analytics pro-
critical, and agencies need to innovators must elicit support grams scales to the rest of the
know that the data they have is from their peers and senior of- agency.
the right data for the problem ficials.
they are trying to solve. Once 8. Choose the proper re-
the right data has been iden- Although budgets may not porting techniques.
tified, agencies can begin to be flexible enough to allow
benchmark data and measure it, typically it makes sense to This report touched on a
against past performance for have an analytics group within few of the report techniques
any indicators they define. As the agency. A small, focused that can be used for govern-
one survey participant identi- and passionate team is neces- ment agencies. They need to
fied, “Benchmarking as anoth- sary for analytics. Team mem- be sure that the techniques
er data point to judge success; bers should feel empowered match the needs of the orga-
informed decision making.” to work in high functioning nization. In many instances,
and collaborative environ- agencies are collecting vari-
5. Address challenges for ments. With a passionate team, ous kinds of data across the
implementation. analytics can move to broader agency, combining data from
adoption at the agency. different sources and running
Analytics presents a lot of chal- advanced analytics programs.
lenges. Be sure to map these 7. Start small and build Clearly, to streamline informa-
out front and think strategi- quick wins through a pilot. tion, agencies need to set re-
cally how to solve and work porting strategies for different
through challenges. One strat- “It may cost and take time to channels and resources. It is
egy is to engage core stake- run through scenarios/do a the responsibility of agencies
holders up front, and continue feasibility study before in- to present a coherent report-
to integrate them throughout stallation, testing, and imple- ing strategy to its employees
the process. This means clear- mentation, but it’s worth the and constituents that cater to
ly defining impact on related trouble,” states a survey par- a specific analytics need.
programs, which employees ticipant.
decisions. Leaders should en- truly successful, the program learned the best analyses are
will be directly involved, and 9. Map to strategic needs
strategies needed. Like many IT initiatives, ana- at the agency.
courage analytics programs needs to be clearly mapped to- best completed by those who lytics programs will take some It’s imperative that the agency
within an agency, and work to wards an organizational chal- have a clear understanding
craft a culture that makes data lenge or deficiency that can be of the mission of the agency
6. Assess workforce and time, and agencies should fo- map out the strategic goals of
build support team. cus on small iterations to im- analytics and what problem
based decisions. solved with proper data analy- and defined goals of the web- prove. Success will not occur they are trying to solve. Once
sis. sites. Additionally, there must overnight. If agency leaders
Training for analytics is essen- that foundation is set, agencies
3. Get a clear vision of how be a plan for implementation
tial. Once an analytics program can start by having a small can work to identify the cor-
to use analytics to solve a The importance of having a based on analytics gathered pilot program and gaining a
has kicked off and started, ev- rect data streams, the format
problem . clear vision became extremely even with the current state of few quick wins to show value
eryone on the team should of the data, and the tools and
clear throughout our inter- the budget. of analytics, the program will
know how to use the tools and resources needed to achieve
For analytics programs to be views and survey. One sur- have more support and suc-
access the information. Analyt- the end goal. It’s all about, as
vey respondents said, “I have 4. Identify the right data.
17. THEGOVLOOPGUIDE 33.
32. GOVERNMENTANALYTICS
stated by Engel, “making sure
that the application, the types
of events, that the source of
the data that you want to ana- I t may cost and take time to run through
scenarios/do a feasibility study before
installation, testing, and implementation,
I have learned the best analyses are best
completed by those who have a clear
understanding of the mission of the agency
lyze have the appropriate data
to enable you to ask the ques- but it’s worth the trouble.” and defined goals of the websites. Addition-
tions that you want to answer.” ally, there must be a plan for implementa-
This process is at the core of GovLoop Survey Participant tion based on analytics gathered even with
any analytics program for gov- the current state of the budget.”
ernment.
GovLoop Survey Participant
10. Understand any cul-
tural shifts that may take
place.
“Building an analytical culture,
where data is widely used to
evaluate deductions, is criti-
cal to becoming an analytical-
ly competitive organization,”
states a GovLoop survey par-
ticipant.
B enchmarking as another data point
to judge success; informed decision
making.”
B uilding an analytical culture, where
data is widely used to evaluate de-
ductions, is critical to becoming an analyti-
cally competitive organization.”
With analytics, there may be GovLoop Survey Participant
changes to culture, and lead- GovLoop Survey Participant
ers will potentially be faced
with organizational and cultur-
al challenges. These challeng-
es are common in any kind of
technology adoption. Leaders
must be aware that these chal-
lenges will be down the road.
Imperative to the success of an
analytics program is for a lead-
er to show the underlying or-
ganizational value of analytics
and how it will help guide the
agency towards its goals. Fur-
ther, a leader must be sensitive
to any changes to the day –to-
day changes for employees.
In addition, agencies must be
aware of wider culture shifts,
especially in the realm of tech-
nology.
18. THEGOVLOOPGUIDE 35.
34. GOVERNMENTANALYTICS
5 Questions to Ask for
Analytics Initiatives
Whether it is bringing challenges to lead- Do employees have access to the right in-
ership, identifying value, or understanding formation?
costs, agencies today are exploring how to
understand how to truly leverage the power What problems are we trying to solve or
of analytics. As many government websites what service needs improvement?
are becoming increasingly transactional and
services move to self-service platforms, it’s be- How do agencies connect the dots and ac-
coming clear that with the volume of data that cess other data?
government collects, creates, stores and man-
ages, can be used to transform how services What new value has been created for cus-
are delivered. For government leaders looking tomers and what’s the return on investment?
to implement an analytics program, five basic
questions come to mind to assist in the deci- How do we show that value to leadership
sion making process: and change culture with data?