With unemployment application submissions reaching record numbers over the past year, state and local agencies in the United States have faced the challenge of processing unprecedented numbers of claims per week. The digital infrastructure most agencies have in place is unable to handle this volume, resulting in constituents waiting longer, and bad actors taking advantage of vulnerable systems. The Department of Labor Inspector General estimates that $63 billion in claims distributed is either an improper payment or fraud. 

Validating claims also requires secure data sharing with other agencies for document and identity verification. Government leaders need a way to allow case adjudicators to quickly and confidently release backlogged claims, integrate with existing systems, and segment legitimate claims from potentially fraudulent ones — all within limited government budgets — securely and at scale.

Implementing a fraud detection solution on Google Cloud

States were under pressure to release payments, while also filtering out potentially fraudulent claims. SpringML and Google Cloud developed a framework to give adjudicators a reliable verification process that quickly filters potentially fraudulent claims, while processing the remaining claims so benefits reach citizens in a timely manner. SpringML and Google Cloud, applied AI-powered machine learning models to detect anomalous patterns in large datasets. Using Google Cloud tools, SpringML implemented a solution to streamline workflows, improve efficiencies, automate processes and identify potentially fraudulent claims.

SpringML used a variety of Google Cloud products to deliver a fraud detection solution, including:

• Google Cloud Storage to store and manage data
• BigQuery to store tabular data and BigQuery Machine Learning (BQML) to conduct machine learning on that data
• AutoML solutions to build predictive models and risk scoring
• Visualization tools such as Looker and Data Studio to present data and help government leaders make informed decisions.

Implementing machine learning to detect improper payments allows agencies to classify claims as “fraud” or “not fraud” based on the number of flags, as well as prioritize the most urgent claims. Deploying intelligent virtual agents to handle frequently asked questions meant that live agents could focus their time on more challenging cases. 

Even once the pandemic is behind us, there will be bad actors trying to take advantage of overwhelmed or legacy systems. We’ve identified a few best practices for agencies managing enormous case loads and looking to improve improper payment analytics: 

• Move your systems to the cloud. Many on-premises legacy systems can’t update their applications and scale to meet the volume of claims. Moving to a cloud environment enables rapid solution deployment and ingestion of large amounts of data without fear of overloading the system. The cloud scales with you–cost-effectively and securely. 
• Understand patterns in the data. The answer is always in the data — we used deep analysis to help uncover suspicious patterns in large data sets. We implemented unsupervised machine learning to learn behaviors and create configurable rules that adjust to new information that comes into the system. We can uncover patterns that are likely associated with fraud – ones that a human might have missed. 
• Use AI/ML tools to automate your existing systems and teams. These tools enable humans to work smarter and more efficiently. We automate anomaly detection and create dashboards for adjudicators to rapidly process claims. We are enabling the Wisconsin Department of Workforce Development by implementing automatic calculations and processing of recharge amounts, resulting in faster processing times and fewer human errors. Proactive fraud detection and timely calculation of recharge payment allowed DWD to ensure the benefits reached the right individuals.
• Build flexibility into your systems. We discovered that fraud patterns change over time. For instance,flags for fraud during March-May 2020 were vastly different from those we found in June-July 2020. Google Cloud tools make it easy to continually update algorithms to detect patterns and integrate external data sources.

Using Google Cloud tools, we can update digital infrastructure and incorporate machine learning best practices to help organizations efficiently process large volumes of claims and identify high probability fraudulent ones. SpringML provides consulting and implementation services and industry-specific analytics solutions that deliver high-impact business value to accelerate data-driven digital transformation. Learn more about fraud detection and how to improve improper payments analytics by watching our webinar. 

Advances in artificial intelligence (AI) and machine learning (ML) have led to increased adoption in the financial services sector. A prominent use for this technology is to assist in key compliance and risk functions, including the detection of fraud, money laundering, and other financial crimes and illicit finance, as well as trade manipulation — collectively referred to as “Risk AI/ML.” As the use of these models grows, so do questions about managing risks associated with the models. 

In particular, regulators, financial institutions, and technology service providers have been looking into whether existing Model Risk Management (MRM) guidance — which has traditionally been the regulatory regime applicable to managing model risk in the financial services industry — continues to be relevant for AI/ML models. And, if so, how should the guidance be interpreted and applied to this new technology?

As the financial sector increasingly adopts artificial intelligence and machine learning techniques, it is critical for regulators, financial companies and technology providers to work together to assure that there are clear rules of the road,” says Jo Ann Barefoot, AIR CEO and co-founder. “Updated guidelines on the responsible use of these models can help prevent novel technologies from causing harm, and can also open up better ways to combat risk in areas like money laundering, illicit finance, and fraud.

Our new white paper, written in partnership with the Alliance for Innovative Regulation (AIR), seeks to address that question, with the aim of fostering thought and dialogue among agencies, the financial services industry, risk model vendors, and entities interested in the performance, outputs, and compliance of models used to identify, mitigate, and combat risks in financial services. This white paper does not address issues that may arise with other applications of AI/ML in the financial services industry, such as consumer credit underwriting or models using generative AI or Large Language Models, which are better addressed iteratively. 

The paper argues that MRM guidance, given its broad, principles-based approach, continues to provide an appropriate framework for assessing financial institutions’ management of model risk, even for Risk AI/ML models. Working within an existing framework takes advantage of the knowledge and operational capabilities of institutions that already understand this framework, instead of having to create an entirely new approach, which generally takes longer to implement and make effective. Nonetheless, the paper recognizes that AI/ML models have unique traits and characteristics compared to conventional models, including their potential dynamism and pattern recognition capabilities. These distinctions must be in focus when considering how MRM guidance should be applied to Risk AI/ML models. 

Taking into account those unique aspects of AI/ML models, the paper offers specific observations and recommendations regarding the application of MRM guidance to Risk AI/ML models, including:

• Risk assessment: In assessing risk, it is important to recognize that AI/ML models are not inherently more risky than conventional models. A risk-tiering assessment must consider the targeted business application or process for which a model is used, as well as the model’s complexity and materiality. To assist in these assessments, regulators could clarify that the use of AI/ML alone does not place a model into a high-risk tier and publish further guidance to help set expectations regarding the materiality/risk ratings of AI/ML models as applied to common use cases.
• Safety and soundness: Due to the dynamic nature of Risk AI/ML models, reliance on extensive and ongoing testing focused on outcomes throughout the development and implementation stages of such models should be primary in satisfying regulatory expectations of soundness. To that end, the development of technical metrics and related testing benchmarks should be encouraged. Model “explainability,” while useful for purposes of understanding the specific outputs of AI/ML models, may be less effective or insufficient for establishing whether the model as a whole is sound and fit for purpose.
• Model documentation: The touchstone for the sufficiency of documentation should be what is needed for the bank to use and validate the model, and understand its design, theory, and logic. Disclosure of proprietary details, such as model code, is unnecessary and unhelpful in verifying the sufficiency of a model and would deter model builders from sharing best-in-class technology with financial institutions.
• Industry standards and best practices: Regulators should support the development of global standards and their use across the financial services and regulatory landscape by explicitly recognizing such standards as presumptive evidence of compliance with the MRM guidance and sound AI/ML risk mitigation practices. In addition, regulators should foster industry collaboration and training based on such standards.

Governance controls: Regulators should use guidance to advance the use of governance controls, including incremental rollouts and circuit breakers, as essential tools in mitigating risks associated with Risk AI/ML models.

In an era where AI technology has the potential to revolutionize financial services, we acknowledge the foresight of our regulators in setting a solid foundation and blueprint for navigating the labyrinth of potential risks through the MRM guidance,” says Philip Moyer, Global VP, AI and Business Solutions at Google Cloud. “We believe there is room for greater coherence and precision, enhanced risk-mitigation approaches, and refined best practices surrounding AI and ML risk models. Whether it’s in capacity building or information sharing, our call to action is for greater collaboration between regulators and financial institutions. We’re confident that our collective efforts today will help shape a more robust and resilient future for financial services.

We invite a discussion of additional considerations, including the importance of examiner and industry training and collaboration, as well as openness by regulators to continue to refine the MRM guidance as AI/ML technologies develop and standards emerge. 

Implementing our recommendations would advance several goals. It would help regulators, financial institutions, and technology providers work together to better serve their shared purpose of protecting the safety and soundness of the financial system. At the same time, implementing the recommendations and continuing work in this space would promote the adoption of cutting-edge technologies in the industry, including those that combat such scourges as money laundering, illicit finance, and fraud.

You can read the full white paper here.

Editor’s note: Today we’re hearing from Ryan Mason, Director, Head of DTC Growth & Strategy, at alcoholic beverage firm, Constellation Brands on the company’s shift to Direct-to-Consumer (DTC) sales and how Google Cloud’s powerful technology stack helped with this transformation. 

It’s no secret that consumer businesses have been up-ended in a lasting manner after 18 months of the pandemic. Consumers have been forced to shop differently over the past year – and as a result, they’ve evolved to be more comfortable with online spending and have grown to expect a certain level of convenience. While the e-commerce share of consumer sales has grown steadily over the past decade, the pandemic was the catalyst for the famous “10 years of growth in 3 months” which many argue is here to stay. 

Facing this reality head-on,  we placed a new emphasis on Direct-to-Consumer (DTC) with our acquisition of Empathy Wines, a DTC-native wine brand that sells directly to consumers via e-commerce. To accelerate our innovation in the DTC space, we added headcount and new functions to the existing Empathy team and empowered the newly-minted DTC group to apply their digital commerce operating model across the rest of the wine and spirits portfolio, which includes Robert Mondavi Winery, Meiomi Wines, The Prisoner Wine Company, High West Whiskey, and more. 

One pandemic and one year later, DTC sales have surged in the wine and spirits category with Constellation positioned as a leader armed with a unique and powerful cloud technology stack, best-in-class e-commerce user experiences, modernized fulfillment solutions, and data-driven growth marketing. 

Benefits of Going DTC 

A report from McKinsey estimates that the strategic business shift to DTC has been accelerated by two years because of the pandemic and argues that consumer brands that want to thrive will need to aim for a 20% DTC business or higher, which is already taking shape in the market: Nike’s direct digital channels are on track to make up 21.5% of the total business by the end of 2021, up from 15.5% in the last fiscal year, and Adidas is aiming for 50% DTC by 2025. But outside of the clear revenue upside, the auxiliary benefits of going DTC are robust.

For Constellation Brands, each of these four pillars ring true, and our shift toward DTC is as much about margin accretion and revenue mix management as it is about consumer insights and data. The added complexities of the alcohol space add wrinkles to our DTC approach and manifest in many areas like consumer shopping preference, shipping and logistics hurdles, and more. In order to win share early and continue to lead the category, we recognized the need to harness the immense amount of first-party data to power impactful and actionable insights. 

Our DTC technology architecture has fostered a value chain that is completely digitized: website traffic, marketing expenditures, tasting room transactions, e-commerce transactions, logistics and fulfillment events, cost of goods sold (COGS) and margin profiles, etc. are recorded and stored in a data warehouse in real time.  For the first time, at any given moment, we can easily and deterministically answer complex business questions like “what is the age and gender distribution of my customers from Los Angeles who have purchased SKU X from Brand.com Y in the last 6 months? What is the cohort net promoter score? Did that increase after we introduced same-day shipping in this zip code? By how much?” 

The ability to answer these questions and understand the root causes allows us to stay nimble with product offerings and iterate marketing strategies at the speed of consumer preference. Further, it enables us to optimize our omnichannel presence in the same manner by leaning on DTC consumer insights to develop valuable strategies with key wholesale distribution partners and 3-Tier eCommerce partners like Drizly and Instacart. At its core, Constellation’s DTC practice is designed to be the consumer-centric “tip-of-the-spear” responsible for generating insights from which all sales channels, including wholesale, can benefit. 

Constellation’s DTC technology approach prioritizes consumer-centricity and insights generation

We have taken a modern approach to building a digital commerce technology stack, leveraging a hub-and-spoke model built around Shopify Plus and other key emergent technology providers like email provider Klaviyo, loyalty platform Yotpo, Net Promoter Score measurer Delighted, Customer Service module Gorgias, payments processor Stripe, event reservations platform Tock, and many more. For digital marketing and analytics, we use Google Cloud and Google Marketing Platform, which includes products like Analytics 360, Tag Manager 360, and Search Ads 360.

To help gather, organize, and store all of the inbound data from the ecosystem, we partnered with SoundCommerce, a data processing platform for eCommerce businesses. Together with SoundCommerce, we are able to automate data ingestion from all endpoints into a central data warehouse in Google BigQuery. With BigQuery, our data team is able to break data silos and quickly analyze large volumes of data that help unlock actionable insights about our business.  BigQuery itself allows for out-of-the-box predictive analytics using SQL via BigQuery ML, and a key differentiator for us is that all Google Marketing Platform data is natively accessible for analysis within BigQuery. 

But data possession only addresses half of the opportunity: we needed a powerful and modern business intelligence platform to help make sense of the vast amounts of data flowing into the system. Core to the search was to find a partner that approached BI in a way that fit with our future-looking strategy.

Our DTC team relies on the accurate measurement of variable metrics like Customer Acquisition Cost (CAC), Customer Lifetime Value (CLV), Churn, and Net Promoter Score (NPS) as a bellwether of the health of the business and monitoring these figures on a daily basis is paramount to success. To enable us to keep an accurate pulse on strategic KPIs, we considered several incumbent BI platforms. Ultimately we selected Google Cloud’s Looker for a range of benefits that separated it from the rest of the pack.

From a vision perspective, in this particular case we felt Looker was most aligned with our belief that better decisions are made when everyone has access to accurate, up-to-date information. Looker allows us to realize that vision by surfacing data in a simple web-based interface that empowers everyone to take action with real-time data on critical commercial activities. Furthermore, Looker’s ability to automate and distribute formatted modules to a myriad of stakeholders on a regular cadence increases data literacy and business performance transparency.

From a product perspective, we chose Looker for it’s cloud offering, web-based interface, and  centralized, agile modeling layer that creates a trusted environment for all users to confidently interact with data — without any actual data extraction. While other BI tools have centralized semantic layers that require skilled IT resources, we’ve experienced that those can lead to bottlenecks and limited agility. With Looker’s semantic layer, LookML, our BI Team, led by Peter Donald, can easily build upon their SQL knowledge to add both a high degree of control as well as flexibility to our data model.  The fully browser-based development environment allows the data team to rapidly develop, test, and deploy code and is backed by robust and seamless Git source code management. 

In parallel, LookML empowers  business users to collaborate without the need for advanced SQL knowledge. Our data team curates interactive data experiences with Looker to help scale access and adoption. Business users can explore ad hoc analysis, create dashboards, and develop custom data experiences in the web-based environment to get the answers they need without relying on IT resources each time they have a new question, while also maintaining the confidence that the underlying data will always be accurate. This helps us meet our primary goal of providing all businesses users with the data access they need to monitor the pulse of key metrics in near real-time.

Impact and future of DTC BI at Constellation

In short order, taking a modern and integrated approach to the DTC technology stack has delivered economic impact across the portfolio, helping our team understand and combat customer churn, increase conversion rates, and optimize the customer acquisition cost (CAC) and customer lifetime value (CLV) ratios. Perhaps most important is the benefit it can provide to the customer base. Mining customer data and consumer behavior generates data into what our customers are seeking, giving us insights to supply more, or less of it. For example, observing sales velocity and conversion rates by SKU or by region can help us better understand changes in customer taste profiles and fluctuations in demand, providing the foundation for a more powerful innovation pipeline and more effective sales and distribution tactics in wholesale. Our team has also been an early pilot tester for Looker’s new integration with Customer Match, which contributes to the virtuous cycle between data insight and data activation. In the future, our plan is to leverage this cycle to amplify the impact of Google Ads across Search, Shopping, and YouTube placements for the wine and spirits portfolio. 

The operational impact of Looker is also substantial: our team estimates that the number of hours needed to reach critical business decisions has been reduced by nearly 60%, boosting productivity and accelerating the daily operating rhythm. A thoughtfully curated technology stack together with a modern BI solution allows us to stay at the vanguard of the industry. While the DTC sales channel is not designed to surpass the core business of wholesale for Constellation in terms of size, the approach enables unparalleled insights and measurement abilities that will pay dividends for the entire business for years to come.

For a business to succeed in the long term, it needs to learn not just to adapt to inevitable change, but to harness it. South Africa-based PPS has been an insurance company since 1941 and today is the biggest mutual insurance provider in the country.

As a mutual company, PPS is owned by more than 200,000 members, making them shareholders. In recent years, PPS and other companies like it have been affected by a number of external factors.

“For one thing, technology platforms have brought in a new gig economy that has all kinds of implications for insurance,” says Avsharn Bachoo, CTO at PPS. “What we’ve been seeing is basically a disruption of the South African insurance industry. We chose to see that as an opportunity.”

“Our servers were at the end of their life cycle and we had to decide whether to refresh them or switch completely. To embrace the world of AI and machine learning effectively, we knew we needed a cloud-based infrastructure. We’ve found the answer in Google Cloud Platform.”

—Avsharn Bachoo, CTO, PPS

In early 2018, faced with an uncertain economic environment that was squeezing growth and profitability, PPS decided to transform itself from a traditional broker-based business into a digital insurance provider. A key pillar of this new strategy was to overhaul the company’s technology infrastructure. To turn the strategy into reality, Avsharn and his team chose Google Cloud Platform (GCP).

“Our servers were at the end of their life cycle and we had to decide whether to refresh them or switch completely,” says Avsharn. “To embrace the world of AI and machine learning (ML) effectively, we knew we needed a cloud-based infrastructure. We’ve found the answer in Google Cloud Platform.”

Power, speed, flexibility with Google Cloud Platform

Previously, PPS maintained an on-premises IT infrastructure, which worked for its traditional business but was unsuited for its new way of working. In early 2018, the company started working on new products for its members but this required large amounts of compute power that proved prohibitively expensive with on-premises servers. Even existing products were starting to require more than the infrastructure could deliver. Aging equipment meant that it’s testing and quality assurance environments bore little resemblance to the actual production environment.

“We had no pre-production environments at all,” says Avsharn, resulting in more work for developers after products had been released. Meanwhile, the capital required to buy and configure more servers for new projects meant fewer resources available for innovation, and left the company less able to react to changes in the market. PPS knew it had to find a cloud-based alternative.

Shortly after devising a new digital strategy, PPS engineers attended a training session on cloud infrastructure given by leading South African Google Cloud Partner Siatik. Impressed with the presentation, PPS engaged Siatik to help run a proof of concept for a cloud-based infrastructure, running on GCP. With on-site engineers and constant communication, Siatik formed a very close working relationship with PPS. “The team at Siatik was exemplary,” recalls Avsharn. “They were well-organized, with cutting-edge technical acumen and very creative solutions to our problems. They were real game-changers.”

“We wanted the platform to retrain its models in response to new data and improve its recommendations with more information. Normally this would be a manual process but Google Cloud ML Engine lets the models do this automatically.”

—Kimoon Kim, Lead Solution Architect and Data Engineer, Siatik

The proof of concept was successful, with GCP outperforming the existing infrastructure in terms of how it handled compute demands, databases, and storage.

“It’s the speed of GCP that really impresses us,” says Avsharn. PPS saw that GCP wasn’t just an opportunity to migrate its existing infrastructure to the cloud. With Siatik’s help, it redesigned its monolithic core architecture to one based around microservices using Google Kubernetes Engine (GKE). For data processing and storage, Cloud Dataflow and Cloud Datastore proved invaluable, while Stackdriver helped the IT team stay on top of logging and monitoring the system.

“Google Cloud makes migrations very easy,” says Brett St. Clair, CEO at Siatik. “It takes care of all the hard work with configurations and replications, so when we switch the machines on, everything is ready and working.”

The ease with which PPS migrated to GCP means that it can now tackle strategic goals much more quickly than before. The most ambitious of these is an AI-powered product recommendation platform. Information is collected from customers who opt in at a defined point in their journey, this database is queried using BigQuery, and the information is fed into the platform. The AI model then calculates the most appropriate products for each member, according to their personal history.

“Most of the product recommendation engines out there are based on clustering, where you’re offered products based on your peer groups,” explains Avsharn. “For the first time, we can make recommendations to members based on their individual preferences and historical behavior. That’s really powerful for us.”

Siatik helped PPS use TensorFlow and Cloud Machine Learning Engine to build the AI platform. For the engineers, these easy-to-use tools helped speed up the process considerably, allowing them to host the models locally without any fuss. Previously, it took one to three months to manually build the model and match an offer to a customer. With the AI platform, a match takes just a few minutes. Cloud ML Engine, in particular, helped the platform adapt to new information on the fly and easily make adjustments to its hyperparameters, that is, preset variables which define the model-training process.

“We wanted the platform to retrain its models in response to new data and improve its recommendations with more information,” says Kimoon Kim, Lead Solution Architect and Data Engineer at Siatik. “Normally this would be a manual process but Google Cloud ML Engine lets the models do this automatically.”

“Google Cloud helped us cancel out a lot of the noise around machine learning and AI. We don’t have to build new complicated algorithms or hire huge teams of data scientists to benefit. We just bring our data and use the right tools to focus on what’s really important.”

—Avsharn Bachoo, CTO, PPS

Harnessing artificial intelligence for real-world results

PPS deployed its new AI recommendation platform in December, 2018. Just a couple of months later, its impact was clear. “In around eight weeks, we saw a 5 percent growth in sales,” says Avsharn. “It’s been a direct result of building our recommendation platform with Google Cloud. We can offer the right products to the right members.”

For developers and engineers at PPS, working with Google Cloud gives them access to high performance technology and automation options with GKE. As a result, the infrastructure runs 70 percent faster than before with fewer cores and less memory. Developers can also work in mature testing environments, and for the first time, are able to build pre-production environments, leading to better quality products. More strategically, moving to a serverless, cloud-based infrastructure has helped PPS take control of its budget, moving away from intermittent, large capital spends to more manageable, project-to-project flows of operational expenditure. The company expects to see savings of around 50 percent, or $695,000.

“We have a lot more flexibility with our resources thanks to Google Cloud,” says Avsharn. “When we have a new idea, we don’t have to outlay new capital such as servers before we can even start working on it. We just spin up instances when we want and spin them back down when we’re done.”

With the AI platform deployed and working well, PPS is already looking at ways to improve it, including real-time updates and further automation. Soon, the company will integrate the platform with more sales campaigns for more effective targeting to boost sales even further. Meanwhile, it’s also experimenting with machine learning to spot patterns in data at scale for fraud analytics and risk assessment.

For PPS, working with Google Cloud has helped it transform quickly and effectively from disrupted to disruptor. The company is now looking to gain the same transformative effects by implementing G Suite for increased productivity and collaboration.

“Google Cloud helped us cancel out a lot of the noise around machine learning and AI,” says Avsharn. “We don’t have to build new complicated algorithms or hire huge teams of data scientists to benefit. We just bring our data and use the right tools to focus on what’s really important.”