Capability Lead, Program Integrity, Data Analytics, and Reporting
Brian Simonson has over 20 years’ experience applying his knowledge of statistical analytics, health care policy, and big data management to the area of program integrity. Leveraging classical statistical modeling, machine learning, and advance survey sampling techniques, he has led the development of various approaches to identifying actionable sources of fraud, waste and abuse (FWA).
For the Center for Medicare and Medicaid Services (CMS), Simonson has led evaluation studies measuring the impact of program integrity initiatives, driven policy changes related to Medicare audit operations, and developed payment incentives for Medicare claims processing contractors. In addition, he has developed a generalized approach to developing predictive models that measure the risk of health care providers contributing to FWA.
Simonson currently serves as a statistical expert for the CMS Services’ statistical audits of Medicare and Medicaid. He is an authority in the area of statistical audit techniques and has published on unique estimators for this specific area of research. The methods and techniques developed have been reviewed and accepted by both HHS and VA’s OIG offices, by OMB and by GAO.
Simonson leads organizational programming standardization efforts across the firm. With a focus on automaticity and scalability, he helps drive Lewin’s development of programming capabilities.
Simonson received a bachelor’s degree in economics and a master’s degree in statistics from the University of Virginia.