Global Healthcare Fraud Analytics Market Report 2023: A Large Number of Fraudulent Activities Fuels the Sector
Global Healthcare Fraud Analytics Market
Dublin, May 03, 2023 (GLOBE NEWSWIRE) -- The "Healthcare Fraud Analytics Global Market Report 2023" report has been added to ResearchAndMarkets.com's offering.
This reportprovides strategists, marketers and senior management with the critical information they need to assess the market.
The global healthcare fraud analytics market grew from $2.43 billion in 2022 to $3.09 billion in 2023 at a compound annual growth rate (CAGR) of 27.0%. The healthcare fraud analytics market is expected to grow to $8 billion in 2027 at a CAGR of 26.9%.
Major players in the healthcare fraud analytics market are International Business Machines Corporation (IBM), Optum, Inc., SAS Institute, Inc., Change Healthcare, EXL Service Holdings, Inc., Cotiviti, Wipro Limited, Conduent, Inc., Hindustan Computers Limited Technologies Limited, CGI Inc., DXC Technology Company, Northrop Grumman Corporation, LexisNexis Group, Pondera Solutions, WhiteHatAI, Healthcare Fraud Shield, FraudLens, FraudScope, HMS Holding Corp., Fair, Isaac and Company(FICO), Qlarant, Inc., Codoxo, H20.ai, and OSP Labs, Sharecare, Inc.,
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Healthcare fraud analytics refers to on-premise and on-demand analytical solutions that assist in identifying issues such as duplication/repetition of claims and errors in claim healthcare operations and applications. Healthcare fraud analytics aims to help healthcare companies to audit their accounts and find out fraudulent activities in various transactions. It identifies frauds related to billings, claims, prepayment, post payments, and payment integrity.
The main type of solutions in healthcare fraud analytics are descriptive analytics, predictive analytics, prescriptive analytics. Descriptive analytics is a process of using current and historical data to identify trends and relationships. Healthcare fraud analytic solutions are deployed on-premise and on-demand, and they are widely used for insurance claims review, postpayment review, prepayment review, pharmacy billing misuse, payment integrity, other applications. Healthcare fraud analytics are used by public & government agencies, private insurance payers, third-party service providers.
The healthcare fraud analytics market research report is one of a series of new reports that provides healthcare fraud analytics market statistics, including healthcare fraud analytics industry global market size, regional shares, competitors with a healthcare fraud analytics market share, detailed healthcare fraud analytics market segments, market trends and opportunities, and any further data you may need to thrive in the healthcare fraud analytics industry. This healthcare fraud analytics market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenarios of the industry.
Adopting and developing new technologies is a key trend gaining popularity in the healthcare fraud analytics market. The major companies are focusing on launching statistical data analytical and artificial intelligence (AI)-driven product and services to strengthen their market position. These fraud detection techniques perform various statistical operations, including data mining, regression analysis, machine learning, pattern recognition, supervised learning, unsupervised learning, and others.
North America was the largest region in the healthcare fraud analytics market in 2022. North America is expected to be the fastest-growing region in the forecast period. The regions covered in healthcare fraud analytics market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa.
The countries covered in the healthcare fraud analytics market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.
A large number of fraudulent activities in the healthcare sector contribute to the growth of the healthcare fraud analytics market. Medical providers, patients, and third parties who intentionally deceive the healthcare system into acquiring unlawful benefits can commit fraud based on deception or misrepresentation. These fraud and abuse involve kickbacks, billing, billing for services not provided, medical testing, and other fraudulent activities.
For instance, according to Blue Cross Blue Shield Association, a US-based federation, in 2021, The National Heath Care Anti-Fraud Association estimated that health care fraud costs the nation about $68 billion annually, about 3 percent of the nation's $2.26 trillion in health care spending. Other estimates range as high as 10 percent of annual health care expenditure, or $230 billion. Thus, the increasing number of fraudulent activities in healthcare is contributing to the growth of the healthcare fraud market.
The healthcare fraud analytics market includes revenues earned by entities by providing services such as fraud detection, predictive analytics, and Medicaid. The market value includes the value of related goods sold by the service provider or included within the service offering. Only goods and services traded between entities or sold to end consumers are included.
The market value is defined as the revenues that enterprises gain from the sale of goods and/or services within the specified market and geography through sales, grants, or donations in terms of the currency (in USD, unless otherwise specified).
The revenues for a specified geography are consumption values that are revenues generated by organizations in the specified geography within the market, irrespective of where they are produced. It does not include revenues from resales along the supply chain, either further along the supply chain or as part of other products.
No. of Pages
2023 - 2027
Estimated Market Value (USD) in 2023
Forecasted Market Value (USD) by 2027
Compound Annual Growth Rate
Key Topics Covered:
1. Executive Summary
2. Healthcare Fraud Analytics Market Characteristics
3. Healthcare Fraud Analytics Market Trends And Strategies
4. Healthcare Fraud Analytics Market - Macro Economic Scenario
4.1 COVID-19 Impact On Healthcare Fraud Analytics Market
4.2 Ukraine-Russia War Impact On Healthcare Fraud Analytics Market
4.3 Impact Of High Inflation On Healthcare Fraud Analytics Market
5. Healthcare Fraud Analytics Market Size And Growth
5.1. Global Healthcare Fraud Analytics Historic Market, 2017-2022, $ Billion
5.1.1. Drivers Of The Market
5.1.2. Restraints On The Market
5.2. Global Healthcare Fraud Analytics Forecast Market, 2022-2027F, 2032F, $ Billion
5.2.1. Drivers Of The Market
5.2.2. Restraints On the Market
6. Healthcare Fraud Analytics Market Segmentation
6.1. Global Healthcare Fraud Analytics Market, Segmentation By Solution Type, Historic and Forecast, 2017-2022, 2022-2027F, 2032F, $ Billion
6.2. Global Healthcare Fraud Analytics Market, Segmentation By Delivery Model, Historic and Forecast, 2017-2022, 2022-2027F, 2032F, $ Billion
6.3. Global Healthcare Fraud Analytics Market, Segmentation By Application, Historic and Forecast, 2017-2022, 2022-2027F, 2032F, $ Billion
Insurance Claims Review
Pharmacy Billing Misuse
6.4. Global Healthcare Fraud Analytics Market, Segmentation By End User, Historic and Forecast, 2017-2022, 2022-2027F, 2032F, $ Billion
Public & Government Agencies
Private Insurance Payers
Third-Party Service Providers
7. Healthcare Fraud Analytics Market Regional And Country Analysis
7.1. Global Healthcare Fraud Analytics Market, Split By Region, Historic and Forecast, 2017-2022, 2022-2027F, 2032F, $ Billion
7.2. Global Healthcare Fraud Analytics Market, Split By Country, Historic and Forecast, 2017-2022, 2022-2027F, 2032F, $ Billion
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