Medicaid Fraud

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Proposal of a Quantitative Study Proposal of a Quantitative Study Week 5 Application Introduction Medicaid fraud is a major problem in the healthcare industry that has resulted in losses amounting to billions of dollars and in decline of the public healthcare sector (Krause, 2010). To address the issue, the government and other concerned authorities require information about the extent of the problem and factors that contribute to medical fraud. The authorities also require information about the possible set of solutions that would be realized though qualitative research. Problem Statement Based on the discussion above, it can be said that there are two sets of problems that stand out requiring immediate consideration. Firstly, there is the need to establish the extent of the problem and its impact on the population. Secondly, the researcher will be interested in establishing the reasons that make people indulge in fraud. Both problems will be evaluated through qualitative research methods, whereby the researcher will be assessing the impacts of Medicaid fraud on the US population. To facilitate the process, the researcher will assume the following hypotheses as the basis for relevant research questions. H1: The rate of Medicaid fraud is inversely proportional to people’s income. H2: Medical professionals assist Medicaid fraudsters due to inefficiency and bureaucracy in the healthcare system government institutions. H3: Medicaid fraud increases medical costs due to fraudulent exposure to unnecessary medical procedures. Based on these hypotheses, the researcher will be able to develop the following research questions as the first step towards a successful research exercise. Research Questions 1. Does variation in people’s income contribute to Medicaid fraud? If so, what is the correlation between people’s basic salary and their involvement in Medicaid fraud? 2. What is the role of information technology in cubing Medicaid fraud? Alternatively, does technology contribute to Medicaid fraud? 3. The criminal investigation department has ruled that Medicaid fraud is a form of crime. What are the views of the people concerning the criminalization of Medicaid fraud? (a) Do people consider Medicaid fraud as a criminal activity? (b) Do people blame the authority for their misfortunes? 4. What is the role of medical and legal professionals in Medicaid Fraud? The research questions are immediate extensions of the stated hypotheses and, therefore, they provide the first proof for the stated hypotheses (Shadish, Cook, amp. Campbell, 2001). Moreover, the research design allows the researchers to test the viability of the hypotheses before conducting the actual research or experiment. The proposed study will employ ex post facto design due to the nature of the identified problems. Ex post facto research is a systematic inquiry that assumes existence of empirical relationships between research variables (Creswell, 2008). In this research design, the researcher does not have direct control over the parameters. The research will attract two sets of population for effective data collection and analysis. The first set 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. Data Collection The proposed study will employ questionnaires as the main data collection tools. The collected data will be used to measure independent and dependent variables. According to the identified population, Medicaid fraud will be identified as the main dependent variable while people’s living standard, levels of income, age, and education will be identified as the main independent variables. The collected data will be used to measure the extent or the quantity of Medicaid fraud in the country. In addition, the data will be used to measure variation of fraud within the different settings. Lastly, the data will provide reasons for people’s involvement in Medicaid fraud. The choice of research method was inspired by the nature of the problem and availability of resources. Researchers are interested in identifying explicit relationships between research variables (Campbell amp. Stanley, 1963). However, all relationships cannot be expressed as explicit mathematical relationships. Thus, the researcher will be confident with establishing the factors or reasons that cause Medicaid fraud. The researchers will also be required to ensure credibility of their data in order to obtain credible results. To enhance data credibility, the questionnaires will mainly utilize closed-ended questions. Collecting sufficient data from a variety of respondents will also minimize possible errors. Data Cleaning and Analysis After collecting raw data from the field, the researchers will be required to conduct data cleaning before undertaking data analysis procedures. The analysis process will utilize data analysis software SPSS. This step will be followed by drafting of a report and presentation of the research findings to the target audience. Target audience for the project includes government officials, healthcare and judicial professionals, health insurers, students and the public. The main aim of the presentation will be informing the various stakeholders about the extent of the problem and making the appropriate recommendations. References Campbell, D. T., amp. Stanley, J. (1963).Experimental and quasi-experimental designs for research. Boston: Houghton-Mifflin. Creswell, J. W. (2008). Research design: Qualitative, Quantitative, And Mixed Methods Approaches (3rd ed.). Thousand Oaks, CA: Sage. Krause, J. H. (2010). Following the money in health care fraud: Reflections on a modern-day yellow brick road. American Journal of Law amp. Medicine, 36(2/3), 343-369. Shadish, W. R., Cook, T. D., amp. Campbell, D. T. (2001).Experimental and quasi-experimental designs for generalized causal inference(2nd ed.). Boston: Houghton-Mifflin.