The Machine Learning Hunt for Healthcare Fraud

Healthcare fraud is a massive problem worldwide, sucking up billions of dollars each year. Experts have taken up the challenge using machine learning. They started by cleaning and preparing massive amounts of data for analysis. Next, they experimented with various models, picking the best ones for the job. By combining several models using techniques like voting, weighted averages, and stacking, they got even better results. To understand how these models make their decisions, experts used tools like Partial Dependence Plots (PDP), SHAP, and LIME. These tools break down each feature's contribution to the final prediction. When compared to other methods, this approach showed a significant improvement in detecting healthcare fraud. Plus, it gave new insights into how machine learning models work.