Trust & Tech: How Serco is Fighting Fraud in Public Benefits

How do you protect a system that provides essential healthcare access to millions of Americans from increasingly sophisticated fraud?

In the latest episode of the Serco Tech and Innovation Podcast, we sit down with David Cummins, Serco's Senior Vice President of Citizen Services and a newly appointed member of Virginia's Health Exchange Advisory Committee. David shares a fascinating look at the decade-long journey of supporting the ACA Marketplace, from its early days of manual processing to today's AI-driven operation that handles six times the volume with a fraction of the staff.

The conversation explores how Serco has become a vital partner to the government, balancing the dual mission of expanding access to healthcare while protecting taxpayer dollars. David discusses the evolution of fraud, from forged documents to complex "ghost account" schemes orchestrated by bogus brokers. He explains how Serco leverages a combination of advanced technology and experienced employees to safeguard the system.

Don Styer framed the core issue facing government programs today:

"The most important thing for industry as they partner with government to continue or to create programs like this, programs that kind of flip the script, is to improve the citizen's experience while still being efficient."

The discussion reveals that the answer to matrix lies in aligning incentives and taking a proactive, tech-forward approach. By shifting from traditional contracting models to a fixed-unit-price structure, Serco is incentivized to innovate, enhance efficiency, and deliver better results for both the government and its citizens.

David Cummins highlights the pride Serco takes in this unique partnership:

"One of things that we are most proud of: we are able to reduce our price to our customer year over year, since the start of the program 12 years ago, while increasing outcomes."

This episode unpacks how technology, process, and people can converge to solve critical challenges in public service. Listen to the Serco Tech and Innovation Podcast on Spotify.