The global demand for Healthcare Fraud Analytics Market is presumed to reach the market size of nearly USD 20.02 BN by 2030 from USD 3.3 BN in 2022 with a CAGR of 25.3% under the study period 2023 - 2030.
Healthcare fraud analytics is a set of analytical methods that aid in identifying issues like claim submission form errors and claim duplication/repetition. Using a fraud detection tool enables healthcare organizations to audit and account for analytical data approaches. Health care fraud practice involves scamming government healthcare plans, insurance companies, companies, and consumers, among other things. To avoid these fraudulent actions, top health sciences companies are currently implementing various data mining strategies. Data mining techniques entail studying databases to discover new information, like health care insurance data, fraud strategies, health care information systems, and so on.
Market Dynamics
The rise in analytics use in healthcare business processing outsourcing (BPO), the installation of fraud risk management solutions, and the introduction of social media are the prominent trends driving market expansion. The increase in the number of patients seeking health insurance, and the high number of fraudulent activities in healthcare, are projected to fuel the healthcare fraud analytics market growth. Furthermore, excellent return on investment and an increase in pharmacy claim-related fraud also drive the market growth. However, the high cost of these health care fraud detection software and services, a scarcity of experienced employees, and a lack of adoption and awareness of health care fraud analytics services in nations are projected to stifle growth.
The research report covers Porter's Five Forces Model, Market Attractiveness Analysis, and Value Chain analysis. These tools help to get a clear picture of the industry's structure and evaluate the competition attractiveness at a global level. Additionally, these tools also give an inclusive assessment of each segment in the global market of healthcare fraud analytics. The growth and trends of healthcare fraud analytics industry provide a holistic approach to this study.
Market Segmentation
This section of the healthcare fraud analytics market report provides detailed data on the segments at country and regional level, thereby assisting the strategist in identifying the target demographics for the respective product or services with the upcoming opportunities.
By Solution Type
- Descriptive Analytics
- Prescriptive Analytics
- Predictive Analytics
By Delivery Model
By Application
- Insurance Claim Review (Postpayment Review, Prepayment Review)
- Pharmacy Billing Issue
- Payment Integrity
- Others
By End User
- Public & Government Agencies
- Private Insurance Payers
- Third-Party Service Providers
- Employers
Regional Analysis
This section covers the regional outlook, which accentuates current and future demand for the Healthcare Fraud Analytics market across North America, Europe, Asia-Pacific, Latin America, and Middle East & Africa. Further, the report focuses on demand, estimation, and forecast for individual application segments across all the prominent regions.
Global Healthcare Fraud Analytics Market Share by Region (Representative Graph)
The research report also covers the comprehensive profiles of the key players in the market and an in-depth view of the competitive landscape worldwide. The major players in the Healthcare Fraud Analytics market include IBM, Optum Inc., Cotiviti Inc., DXC Technology, SAS Institute Inc., EXL Service Holdings Inc., Wipro Limited, Conduent Inc., HCL Technologies Limited, OSP Labs. This section consists of a holistic view of the competitive landscape that includes various strategic developments such as key mergers & acquisitions, future capacities, partnerships, financial overviews, collaborations, new product developments, new product launches, and other developments.
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