Stats Society NSW Monthly Meeting: Statistical Analysis in Private Health Insurance

The next monthly meeting of the NSW branch of the Statistical Society is tomorrow
evening.  Details are below.  

Best wishes, 

Michael 




Venue: CB04.05.430.  Level 5, University of Technology, Sydney - Building 4 745 Harris
Street, Broadway 

Directions: Building 4 is located on the corner of Thomas and Harris Street, Ultimo.
The best entrance to use is on the Harris Street side, the one immediately beside the
ActiveFitness gym.  

Speaker: Michael Douman(Head of Business & Clinical Analysis, Bupa Australia) 

Title: Statistical Analysis in Private Health Insurance 

Abstract: 

Australia spends approximately $170 billion a year on health, of which private health
expenditure is $84 billion.  Of total private health expenditure, private health
insurance accounts for approximately 8%, or $13 billion.  The presentation focuses on
statistical analysis in private health insurance in Australia with the focus being on
Bupa Australia, and in particular: ​fraud prevention and claims leakage; hospital,
medical and ancillary provider contracting; product (insurance policies) development.
This does not represent all the statistical analytics undertaken by Bupa Australia.
Other work is undertaken by other analytical teams eg Marketing, and Bupa telehealth.  

The presentation will encompass: the extent and nature of the data analysed; the
questions asked and the statistical techniques employed with their respective strengths
and weaknesses; the skills required; the tools used; the future of Health Analytics;
current needs that are holding things back.  

Biography of Michael Douman: 

Michael is the Head of Business & Clinical Analysis with the Bupa Australia Group.  He
has worked for 19 years in Private Health insurance in a number of roles encompassing:
clinical analysis; benefits management; fraud analytics; IT; finance; marketing;
property; HR; and training.  

Immediately prior to that, he spent 7 years in the Victorian public hospital sector
involved with planning in acute, rehabilitation and aged care services during the period
of the introduction of Casemix funding.  

His earlier career encompassed: strategic, commercial, legal, policy & political
analysis in the Tasmanian State public sector in the Cabinet Office,establishing a semi
Government economic development agency,State Government Ministerial advisor to two
Ministers, 5 years as an academic in Universities in NSW and Queensland,research in the
Federal public service in a number of roles in Parliament House and the Department of
Foreign Affairs.