Factors That Contribute to Medicare Fraud - Essay Example

This draft proposal outlines strategies that can be used to evaluate the problem and possible solutions through a mixed-method approach.
Problem Statement

Medicare fraud is one of the overarching problems in the healthcare industry resulting in losses of billions of dollars each year. It is claimed, “Medicare fraud costs the U.S. government approximately $80 billion a year (Stefanacci, 2010). Through a quantitative approach, the researcher will be required to estimate the loss of revenue through Medicare fraud. Secondly, the researcher will be required to establish variations of involvement in Medicare fraud across different societies.
The quantitative aspect of the study will establish the reasons or the social factors that contribute to Medicare fraud. Patterns of fraud cases across different population settings will also be an interesting aspect of the research. Finally, the study will require establishing how medical and legal professionals contribute to Medicare fraud and d the factors that contribute to the involvement.

Purpose Statement
The purpose of this research will be to quantify or measure the current situation regarding the research questions. The study will also require establishing the relationship between historical data and current conditions.

Research Questions
1. How does variation in people’s income contribute to Medicare fraud?
2. What is the correlation between people’s basic salary and their involvement in Medicare fraud?
3. What is the role of information technology in cubing Medicare fraud? Alternatively, does technology contribute to Medicare fraud?
4. The criminal investigation department has ruled that Medicare fraud is a form of crime. What are the views of the people concerning the criminalization of Medicare fraud? (a) Do people consider Medicare fraud as a criminal activity? (b) Do people blame the authority for their misfortunes?
5. What is the role of medical and legal professionals in Medicare Fraud?

Research Design
The study will be conducted through a mixed-method approach whereby the researcher will be interested in quantifying and interpreting different parameters related to Medicare fraud (Creswell, 2008). The choice of mixed methods was inspired by the nature of the problem and the expectations of the audience. For instance, the audience is interested in determining the extent of the problem and the factors that contribute to the problem. In addition, the researcher will be required to develop an explicit mathematical model that defines the relationship between various research parameters such as level of income and Medicare fraud. The qualitative aspect of the study will involve observing the problem and finding relevant literature that corresponds to the research problem (Creswell, 2008). On the other hand, the quantitative approach will enable the researcher to quantify different research parameters.

Population and Participants
From an ideal point of view, the healthcare industry needs a near-perfect system of tracking Medicare fraud for there to be meaningful results. Fraud in the healthcare industry affects all taxpayers. The problem has also affected other sectors of the economy making it an overall economical problem. The problem becomes even more complicated due to the lack of harmonized reimbursement formulas and the implementation of information in the healthcare sector (Krause, 2010). The study will attract two sets of populations. Firstly, the study will target consumers of health services in the country while the second set will consist of medical and legal professionals. A random sample will then be drawn from a list of identified health institutions and homesteads. Research assistants will then be required to collect data from the target population through a random sampling approach.
Data Collection

The main data will be collected through questionnaires and direct interviews while secondary data will be retrieved from past research and the government’s database. Peer-reviewed journal articles and credible medical records will be the main secondary sources of information.
Data Quality and Reliability

Ensuring the quality and credibility of the data will be a significant role in the study. The study will utilize open-ended questionnaires to promote data credibility. In addition, the study will collect sufficient data to minimize the error margin.
Audience
The study will capture people’s attitudes and views toward the problem as well as the extent of the problem. The main audience will include government agencies, health, legal institutions, and the public. The audience will be interested in establishing the range of medical fraud cases and the factors that contribute to Medicare fraud Read More