Seminar – Michael Douman

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Michael Douman

Head of Business & Clinical Analysis, Bupa Australia

Statistical Analysis in Private Health Insurance

Australia spends approximately $170 billion a year on health, of which private health expenditure is $84 billion. Of total private health expenditure, private health insurance accounts for approximately 8%, or $13 billion. The presentation focuses on statistical analysis in private health insurance in Australia with the focus being on Bupa Australia, and in particular:
  • ​fraud prevention and claims leakage
  • hospital, medical and ancillary provider contracting
  • product (insurance policies) development.

This does not represent all the statistical analytics undertaken by Bupa Australia. Other work is undertaken by other analytical teams eg Marketing, and Bupa telehealth.

The presentation will encompass:

  • the extent and nature of the data analysed
  • the questions asked and the statistical techniques employed with their respective strengths and weaknesses
  • the skills required
  • the tools used
  • the future of Health Analytics
  • current needs that are holding things back.

Biography of Michael Douman

Michael is the Head of Business & Clinical Analysis with the Bupa Australia Group. He has worked for 19 years in Private Health insurance in a number of roles encompassing: clinical analysis; benefits management; fraud analytics; IT; finance; marketing; property; HR; and training.

Immediately prior to that, he spent 7 years in the Victorian public hospital sector involved with planning in acute, rehabilitation and aged care services during the period of the introduction of Casemix funding.

His earlier career encompassed:

  • strategic, commercial, legal, policy & political analysis in the Tasmanian State public sector in the Cabinet Office,
  • establishing a semi Government economic development agency,
  • State Government Ministerial advisor to two Ministers,
  • 5 years as an academic in Universities in NSW and Queensland,
  • research in the Federal public service in a number of roles in Parliament House and the Department of Foreign Affairs.



Date:  Tuesday, 10 May 2016

6:00pm – 6:30pm: Refreshments
6:30pm – 7:30pm: Lecture
7:45pm onwards: Dinner (at a nearby restaurant)


Room 430, Level 5, Building 4, University of Technology Sydney (this room is also known as the Maths Grid Room CB04.05.430).


Building 4 is located on the corner of Thomas and Harris Street, Ultimo. The best entrance to use is on the Harris Street side, the one immediately beside the ActiveFitness gym.

Sometimes there might be an issue with after hours access.  If you run into any problems, please call Louise Ryan at 0434 648 583 and she will come down and meet you. For more details regarding directions, click here.

When: 10/05/2016
Time: 6:00 pm
Cost: Free
Location: The University of Technology Sydney (UTS),
Science Faculty, Level 5, Room 5.01, Cnr Harris St & Thomas St,
NSW 2007

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