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Betrugskosten im Gesundheitswesen 2014

LONDON, March 25, 2014 /PRNewswire/ --


Betrug und Fehler kosten weltweiten Gesundheitssektor 487 Mrd. USD pro Jahr

  • Verluste durch Betrug und Fehler im Gesundheitswesen seit 2008 von 5,59 % der Gesamtausgaben um 25 % auf 6,99 % gestiegen
  • Reduzierung von Verlusten durch Betrug und Fehler um bis zu 40 % innerhalb eines Jahres möglich - Freisetzung von 195 Mrd. USD weltweit
  • Globale Durchschnittswerte für Verluste im Gesundheitsdienst des Vereinigten Königreichs auf 7 Mrd. £ geschätzt

Weltweit verursachen Betrug und Fehler laut des neuen Berichts "The Financial Cost of Healthcare Fraud 2014" (Betrugskosten im Gesundheitswesen 2014) der Wirtschaftsprüfungs- und Beratungsfirma BDO LLP in Zusammenarbeit mit dem Centre for Counter Fraud Studies (Studienzentrum zur Betrugsbekämpfung) der Universität Portsmouth jährlich Verluste in Höhe von rund 487 Mrd. USD.

Die Ergebnisse zeigen, dass die durchschnittlichen Verluste im Gesundheitssektor weltweit seit 2008 um 25 % auf 6,99 % gestiegen sind. Im Verhältnis zu den weltweiten Ausgaben für das Gesundheitswesen in Höhe von 6,97 Billionen USD bedeutet dies einen Gesamtbetrag von 487 Mrd. USD pro Jahr bzw.:

  • mehr als das Dreifache des Budgets für das Gesundheitswesen des Vereinigten Königreichs (National Health Service, NHS) 2011/12
  • das Zweieinhalbfache der Ausgaben Kanadas für das Gesundheitswesen 2011
  • fast ein Fünftel der Gesamtausgaben für das Gesundheitswesen in den Vereinigten Staaten 2011 und mehr als 27 % der Gesamtausgaben der EU-Länder im gleichen Zeitraum

Glücklicherweise haben Betrugsbekämpfungsmaßnahmen gezeigt, dass eine Reduzierung der Verluste um 40 % innerhalb von 12 Monaten durchaus realistisch ist. Alleine dadurch würden sich die Ressourcen für das globale Gesundheitswesen um ganze 195 Mrd. USD erhöhen.

Fallstudie

Im National Health Service des Vereinigten Königreichs (der zweitgrößten Organisation der Welt) ließen sich die Verluste zwischen 1998 und 2006 um bis zu 60 % reduzieren. Laut Statistiken des National Fraud Authority Indicator 2013 im Vereinigten Königreich lagen die Kosten für Betrug beim NHS 2013 bei 229 Mio. £, nimmt man allerdings den Prozentsatz der weltweiten Verlustrate an und geht davon aus, dass der NHS den Werten weltweit entspricht, ist eine Summe von ca. 7 Mrd. £ wahrscheinlicher. Der Wert von 229 Mio. £ würde bedeuten, dass der NHS bei der Vermeidung und Erkennung von Betrug und Fehlern dreißig Mal besser abschneidet als der Rest der Welt. Dr. David Evans, Leiter der Abteilung Health Systems Financing (Finanzierung von Gesundheitssystemen) bei der Weltgesundheitsorganisation (WGO) beschreibt die Ergebnisse des Berichts in seinem Vorwort als "überzeugend", während Dr. Simon Peck, Mitbegründer der Health Insurance Counter Fraud Group (HICFG), einer britischen Branchengruppe zur Betrugsbekämpfung im Gesundheitswesen, der 29 führende Krankenversicherungsunternehmen angehören, in seiner Einleitung schreibt, dass diejenigen, die "die Möglichkeit haben, etwas zu ändern", den Bericht lesen sollten.

Und Jim Gee, Leiter der Abteilung Counter Fraud Services (Betrugsbekämpfung) der BDO LLP fügt hinzu:

"Die weltweite Finanzkrise hatte erhebliche Auswirkungen auf die Fähigkeit von Regierungen, Unternehmen und Einzelpersonen, die steigenden Kosten ihrer Gesundheitsanforderungen zu tragen. Diese budgetären Einschränken könnten mit einer konzertierten Maßnahme zur Erfassung, Verwaltung und Minimierung von Kosten durch Betrug und Fehler bei den betreffenden Unternehmen allerdings wesentlich verbessert werden, insbesondere, wenn dies durch rechtliche Auflagen gestützt würde. Unsere konservative Einschätzung geht bei einer ernsthaften Inangriffnahme des Problems davon aus, dass Gesundheitsorganisationen weltweit bis zu 195 Mrd. USD freisetzen könnten, die zurzeit verloren gehen. Dies würde für das Leben von Millionen Menschen rund um die Welt einen wesentlichen Unterschied machen."

Den vollständigen Bericht "BDO Financial Cost of Healthcare 2014" finden Sie unter http://www.bdo.co.uk/services/forensic-accounting/fraud-and-financial-investigations/counter-fraud-services

Informationen zum Bericht

Der "Financial Cost of Healthcare Fraud 2014 Report" ist eine Aktualisierung bereits 2009 und 2011 durchgeführter Studien und trägt die aktuellsten, statistisch begründeten Daten zu wahren Kosten von Betrug und Fehlern im Gesundheitswesen aus der ganzen Welt zusammen (im Gegensatz zu festgestellten oder gemeldeten Betrugsfällen). Insgesamt wertet der Bericht 92 verschiedene Berechnungen zu 14 unterschiedlichen Ausgabentypen im Gesundheitswesen aus, die sich insgesamt auf über 2,99 Billionen USD in 33 Organisationen aus 6 Ländern belaufen. Die Daten, auf die sich die Schlussfolgerungen des Berichts beziehen, sind in der weltweit größten Datenbank zur Betrugsmessung gespeichert und wurden über einen Zeitraum von 15 Jahren hinweg erfasst. Sie beruhen auf akkuraten, statistisch begründeten Berechnungen und beziehen sich auf die Gesamtverluste, nicht nur die erkannten oder gemeldeten Betrugsfälle, die nur einen kleinen Teil der Gesamtkosten ausmachen.

Der Bericht ist ein weiteres Ergebnis der fruchtbaren Zusammenarbeit von BDO LLP, einer führenden Wirtschaftsprüfungs- und Beratungsfirma, und dem Centre for Counter Fraud Studies der Universität Portsmouth (CCFS), Europas führendes Betrugsforschungszentrum.

Pressehinweis

Informationen zu BDO

Die Bereitstellung von Dienstleistungen im internationalen BDO-Netzwerk unabhängiger Mitgliedsunternehmen ("das BDO-Netzwerk") wird koordiniert von der Brussels Worldwide Services BVBA, eine belgische GmbH mit Sitz in Brüssel.

Die BDO International Limited (Verwaltungsgesellschaft des BDO-Netzwerks), die Brussels Worldwide Services BVBA und die Mitgliedsunternehmen sind jeweils separate Rechtspersönlichkeiten und übernehmen keinerlei Haftung für die Handlungen oder Unterlassungen der jeweils anderen juristischen Personen. Die Vereinbarungen oder Bestimmungen des BDO-Netzwerks sind oder implizieren in keiner Form ein Vertretungsverhältnis oder eine Partnerschaft zwischen BDO International Limited, Brussels Worldwide Services BVBA und/oder den Mitgliedsunternehmen des BDO-Netzwerks. 

BDO ist der Markenname des BDO-Netzwerks und jedes Mitgliedsunternehmens.

Die gesamten Gebühreneinnahmen aller BDO-Mitgliedsunternehmen, einschließlich der Mitglieder deren exklusiver Partnerschaften, beliefen sich 2013 auf 6,45 USD. Das globale Netzwerk bietet Beratungsdienste in 147 Ländern an und beschäftigt in 1.264 Vertretungen weltweit über 56.000 Mitarbeiter.

Kontakte im Vereinigten Königreich
Jim Gee, BDO LLP
Tel.: +44(0)20-7893-2830
E-Mail: [email protected]

http://www.bdo.co.uk/press
http://twitter.com/BDOaccountant

Ged Brumby, Smithfield Consultants
Tel.: +44(0)20-7903-0674
Mobil: +44(0)7540-412-301
E-Mail: [email protected]

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