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Global Healthcare Fraud Detection Market – Industry Trends and Forecast to 2028

Healthcare | Upcoming Report | Mar 2021 | Global | 350 Pages | No of Tables: 60 | No of Figures: 220

Report Description

Global Healthcare Fraud Detection Market, By Component (Services, Software), Delivery Mode (On-Premise Delivery Models, On-Demand Delivery Models), Type (Descriptive Analytics, Predictive Analytics, Prescriptive Analytics), End-User (Private Insurance Payers, Public/Government Agencies, Third-Party Service Providers, Employers), Application (Insurance Claims Review, Payment Integrity, Other Application), Country (U.S., Canada, Mexico, Germany, Italy, U.K., France, Spain, Netherlands, Belgium, Switzerland, Turkey, Russia, Rest of Europe, Japan, China, India, South Korea, Australia, Singapore, Malaysia, Thailand, Indonesia, Philippines, Rest of Asia- Pacific, Brazil, Argentina, Rest of South America, South Africa, Saudi Arabia, UAE, Egypt, Israel, Rest of Middle East & Africa) Industry Trends and Forecast to 2028.

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Market Analysis and Insights : Global Healthcare Fraud Detection Market

The healthcare fraud detection market is expected to gain market growth in the forecast period of 2021 to 2028. Data Bridge Market Research analyses the market to grow at a CAGR of 28.92% in the above-mentioned forecast period. Increasing number of fraudulent activities in healthcare drives the healthcare fraud detection market.

Healthcare fraud detection is specially designed to prevent healthcare frauds, abuse and waste so that any unauthorized payment and benefits can be avoided. They are usually used to avoid misrepresenting dates, falsification of data by physicians and submitting claims for services not provided among others.

Increasing number of patients seeking health insurance is the vital factor escalating the market growth, also rising prepayment review model, increasing returns on investment, increase in the pharmacy claims-related fraud, increasing population adapting health insurance and rising need for solutions that have biometric sensors to identify frauds are the major factors among others driving the healthcare fraud detection market. Moreover, increasing adoption of healthcare fraud analytics in developing countries, rising emergence of social media and its impact on the healthcare industry and role of AI in healthcare fraud detection will further create new opportunities for healthcare fraud detection market in the forecasted period of 2021-2028.

However, rising limitations in the data capturing process in Medicaid services, rising less adoption of healthcare fraud analytics and lack of skilled and trained profession are the major factors among others which will obstruct the market growth, while time-consuming deployment and the need for frequent upgrades will further challenge the growth of healthcare fraud detection market in the forecast period mentioned above.

The healthcare fraud detection market report provides details of new recent developments, trade regulations, import export analysis, production analysis, value chain optimization, market share, impact of domestic and localised market players, analyses opportunities in terms of emerging revenue pockets, changes in market regulations, strategic market growth analysis, market size, category market growths, application niches and dominance, product approvals, product launches, geographic expansions, technological innovations in the market. To gain more info on the healthcare fraud detection market contact Data Bridge Market Research for an Analyst Brief, our team will help you take an informed market decision to achieve market growth.

Healthcare Fraud Detection Market Scope and Market Size

The healthcare fraud detection market is segmented on the basis of component, delivery mode, type, end-user and application. The growth amongst these segments will help you analyse meagre growth segments in the industries, and provide the users with valuable market overview and market insights to help them in making strategic decisions for identification of core market applications.

  • On the basis of component, the healthcare fraud detection market is segmented into services and software.
  • Based on delivery mode, the healthcare fraud detection market is segmented into on premise delivery models and on-demand delivery models.
  • Based on type, the healthcare fraud detection market is segmented into descriptive analytics, predictive analytics and prescriptive analytics.
  • Based on end-user, the healthcare fraud detection market is segmented into private insurance payers, public/government agencies, third-party service providers and employers.
  • The healthcare fraud detection market is also segmented on the basis of application into insurance claims review, payment integrity and other application.

Healthcare Fraud Detection Market Country Level Analysis

The healthcare fraud detection market is analysed and market size insights and trends are provided by country, component, delivery mode, type, end-user and application as referenced above.

The countries covered in the healthcare fraud detection market report are U.S., Canada and Mexico in North America, Germany, France, U.K., Netherlands, Switzerland, Belgium, Russia, Italy, Spain, Turkey, Rest of Europe in Europe, China, Japan, India, South Korea, Singapore, Malaysia, Australia, Thailand, Indonesia, Philippines, Rest of Asia-Pacific (APAC) in the Asia-Pacific (APAC), Saudi Arabia, U.A.E, South Africa, Egypt, Israel, Rest of Middle East and Africa (MEA) as a part of Middle East and Africa (MEA), Brazil, Argentina and Rest of South America as part of South America.

Asia-Pacific dominates the healthcare fraud detection market due to rising spending on healthcare analytical services, rising prepayment review model, increasing returns on investment and increase in the pharmacy claims-related fraud in this region. Europe is the expected region in terms of growth in healthcare fraud detection market due to growing integration of artificial intelligence in various healthcare solutions and services in this region.

The country section of the healthcare fraud detection market report also provides individual market impacting factors and changes in regulation in the market domestically that impacts the current and future trends of the market. Data points such as consumption volumes, production sites and volumes, import export analysis, price trend analysis, cost of raw materials, down-stream and upstream value chain analysis are some of the major pointers used to forecast the market scenario for individual countries. Also, presence and availability of global brands and their challenges faced due to large or scarce competition from local and domestic brands, impact of domestic tariffs and trade routes are considered while providing forecast analysis of the country data.

Healthcare Infrastructure growth Installed base and New Technology Penetration

The healthcare fraud detection market also provides you with detailed market analysis for every country growth in healthcare expenditure for capital equipment’s, installed base of different kind of products for healthcare fraud detection market, impact of technology using life line curves and changes in healthcare regulatory scenarios and their impact on the healthcare fraud detection market. The data is available for historic period 2010 to 2019.

Competitive Landscape and Healthcare Fraud Detection Market Share Analysis

The healthcare fraud detection market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in research and development, new market initiatives, global presence, production sites and facilities, production capacities, company strengths and weaknesses, product launch, product width and breadth, application dominance. The above data points provided are only related to the companies’ focus related to healthcare fraud detection market.

The major players covered in the healthcare fraud detection market report are IBM Corporation, Optum, Inc., COTIVITI, INC., McKesson Corporation, Fair Isaac Corporation, SAS Institute Inc., SCIOInspire, Corp., Conduent, Inc., HCL Technologies Limited, CGI Inc., DXC Technology Company, Northrop Grumman, LexisNexis, Pondera Solutions, Wipro, Codoxo and HMS among other domestic and global players. Market share data is available for Global, North America, Europe, Asia-Pacific (APAC), Middle East and Africa (MEA) and South America separately. DBMR analysts understand competitive strengths and provide competitive analysis for each competitor separately.


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