The Effects of Random Undersampling for Big Data Medicare Fraud Detection

We show it is possible to obtain better classification performance for experiments involving highly imbalanced Big Data with the application of data sampling techniques. We apply Random Undersampling to a publicly available Medicare insurance claims dataset of about 175 million records. We find that Random Undersampling significantly improves the classification performance of Extremely Randomized Trees and XGBoost learners in a Medicare Big Data fraud classification task. We employ Random Undersampling to evaluate performance at multiple minority:majority class ratios. According to the outcome of a Tukey’s Honestly Significant Difference test, we find Random Undersampling to the 1:9 or 1:27 class ratios yields the best performance, providing Area Under the Receiver Operating Characteristic scores of over 0.97. Models built with undersampled Big Data require significantly less time to train. Our contribution is to prove the effectiveness of Random Undersampling in classifying Medicare Big Data. Our review of related work shows we are the first to apply Random Undersampling to data on this scale in order to prove one can obtain better performance. To the best of our knowledge, we are the first to perform experiments with the latest Medicare Part D data, made available in 2021.