Medicare Part D Risk Analytics Dashboard

$50B+

Annual Improper Payments

72.46%

Predictive Accuracy (AUC)

33×

Improvement vs Random

$10.6M

5-Year Savings (Moderate)

1.38M

Providers Analyzed

3.7 hrs

Processing Time

System Performance Metrics

72.5%

Temporal AUC

3.3%

Top 1% Precision

Key Achievements

26 Exclusions in Top 1,000

99.9% Legitimate Provider Accuracy

Top Risk Indicators (SHAP Importance)

Total Claims

9.8%

Opioid Share

9.6%

Beneficiary Age

8.6%

Cost/Claim

8.0%

Brand Share

7.8%

Geographic Risk Distribution

Region	Providers	Exclusions	Rate	Risk Level
West	192,314	103	0.054%	1.82× baseline
Southwest	189,443	82	0.043%	1.46× baseline
Southeast	412,837	156	0.038%	1.28× baseline
Northeast	287,419	89	0.031%	1.05× baseline
Midwest	298,652	71	0.024%	0.81× baseline

High-Risk Specialties

Pain Management

2.34× risk

Psychiatry

1.76× risk

Internal Medicine

1.37× risk

Exclusion Rates

Pain Mgmt: 0.089%

Psychiatry: 0.067%

Internal: 0.052%

Implementation Roadmap & Financial Impact

I

Phase I (Years 1-2)

$2.6-7.8M

Real-time API, FHIR/HL7

II

Phase II (Years 3-5)

$26M

Network analysis, Adaptive learning

III

Phase III (Years 5+)

Billions

Full integration: Medicare, VA, TRICARE

Conservative

$8.6M

5-year / Top 500

Moderate

$10.6M

5-year / Top 1,000

Aggressive

$17.2M

5-year / Top 2,000

Full Deploy

$31.8M

5-year / Top 5,000