DLSU Partners with VMR to Tackle Rising Healthcare Fraud with Data Analytics

Manila, Philippines – November 13, 2025 – De La Salle University (DLSU) has partnered with global market research firm Verified Market Research (VMR) to investigate and address the escalating issue of healthcare fraud. The collaboration will leverage VMR’s expertise in data analytics and DLSU’s academic resources to gain deeper insights into emerging fraud techniques and develop strategies to mitigate risks within the Philippine healthcare system, as well as contribute to global understanding of the problem.

Healthcare fraud is a pervasive global issue, costing billions of dollars annually and jeopardizing patient safety. From inflated billing and unnecessary procedures to counterfeit drugs and identity theft, the methods employed by fraudsters are becoming increasingly sophisticated. The Philippines, like many nations, is facing a growing threat, particularly with the expansion of digital health infrastructure and the increasing complexity of insurance claims processing.

“The need for robust fraud detection mechanisms is becoming critical,” says a healthcare administrator familiar with the challenges in the Philippine system. “We are seeing more instances of fraudulent claims and improper billing practices, which drive up costs and erode trust in the healthcare system.”

A Growing Global Problem

The global healthcare fraud analytics market is experiencing significant growth, driven by factors such as the rising cost of healthcare, increasing regulatory scrutiny, and the proliferation of digital health technologies. According to VMR’s research, the market is projected to reach substantial figures in the coming years, with North America currently dominating but the Asia-Pacific region exhibiting the fastest growth. This growth isn't solely driven by increased fraud; it's fueled by the need for preventative measures.

“Organizations are realizing that proactively identifying and preventing fraud is far more cost-effective than dealing with the consequences after it has occurred,” explains a VMR analyst. “Data analytics plays a crucial role in identifying patterns, anomalies, and potential red flags that might otherwise go unnoticed.”

DLSU's Proactive Approach

DLSU’s decision to partner with VMR reflects a proactive approach to addressing this critical issue. The university’s health economics research group recognized the need for a deeper understanding of emerging fraud techniques and the potential benefits of leveraging data analytics to combat them.

“We saw a growing need to understand how digital claims-fraud techniques are evolving and how regulatory changes are impacting the fraud landscape,” explains a DLSU researcher involved in the project. “This partnership with VMR will provide us with the data and insights we need to develop effective strategies for combating fraud and protecting patients.”

The collaboration will involve a comprehensive analysis of global fraud trends, with a specific focus on the Asia-Pacific region and the unique challenges facing the Philippine healthcare system. The research will examine various types of fraud, including insurance claims fraud, pharmacy benefit fraud, and provider fraud. The project will also explore the role of technology, such as artificial intelligence and machine learning, in detecting and preventing fraud.

Leveraging Data Analytics for Prevention

Data analytics offers a powerful tool for combating healthcare fraud. By analyzing large datasets of claims data, patient records, and provider information, analysts can identify patterns and anomalies that might indicate fraudulent activity. Techniques such as anomaly detection, predictive modeling, and data mining can be used to identify potential red flags and prioritize investigations.

“The key is to move beyond reactive fraud detection and embrace a proactive approach,” explains a fraud investigation expert. “By using data analytics to identify and prevent fraud before it occurs, we can save significant costs and protect patients from harm.”

The partnership between DLSU and VMR is expected to generate valuable insights into the latest fraud techniques and best practices for prevention. The research will also inform the development of educational programs and training materials for healthcare professionals and fraud investigators.

Addressing Unique Philippine Challenges

While global trends provide a valuable framework for understanding healthcare fraud, the Philippine healthcare system faces unique challenges. The country's fragmented healthcare landscape, with a mix of public and private providers, and the prevalence of informal payment mechanisms, create opportunities for fraudulent activity.

“The lack of interoperability between different healthcare systems and the limited use of electronic health records make it difficult to track claims and identify fraudulent patterns,” says a healthcare IT consultant. “Improving data sharing and investing in digital infrastructure are crucial steps in combating fraud.”

The research partnership between DLSU and VMR will also address these specific challenges, exploring ways to improve data security, enhance data sharing, and strengthen regulatory oversight. The findings will be shared with policymakers and healthcare stakeholders to inform the development of effective fraud prevention strategies.

Looking Ahead

The partnership between DLSU and VMR represents a significant step forward in the fight against healthcare fraud. By combining academic research with industry expertise, the collaboration is poised to generate valuable insights and inform the development of effective prevention strategies.

“We are confident that this partnership will contribute to a more transparent, efficient, and secure healthcare system,” says a DLSU official. “By working together, we can protect patients, reduce costs, and ensure that healthcare resources are used effectively.”

The research is expected to produce a comprehensive report outlining the latest fraud trends, best practices for prevention, and recommendations for policymakers and healthcare stakeholders. The findings will be disseminated through publications, conferences, and workshops, contributing to a broader understanding of this critical issue. This proactive approach aims to establish the Philippines as a leader in the fight against healthcare fraud, safeguarding both its citizens and its healthcare system.