Healthcare Fraud Detection Market By type (Predictive Analytics, Descriptive Analytics, Prescriptive Analytics), By application (Insurance claims review, Payment integrity), By delivery model (On-premise, On-demand), By component (Services, Software), By end user (Employers, Private insurance payers, Third party service providers, Public/government agencies), Industry Trends, Estimation & Forecast, 2017 – 2025

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Healthcare Fraud Detection Market is expected to grow with a CAGR of xx% during the forecast period of 2018 to 2025.
  • Market Overview:

    Healthcare fraud refers to the fraud of health insurance, drug, and medical practices which involves defrauding insurance company or healthcare plans of government. Data mining is the technique adopted by the leading companies to overcome these fraudulent activities, which requires the knowledge of healthcare systems, frauds, and analysis of healthcare insurance data. According to the Coalition Against Insurance Fraud, each year tens of billions of dollars are stolen by fraudulence in the healthcare industry. Such huge cost of the healthcare fraud to insurance company is the key factor that is fueling the growth of the healthcare fraud detection market across the globe.

    Moreover, increasing number of healthcare BPO and growing implementation of fraud identity management are also driving the growth of the healthcare fraud detection market. However, lack of skilled employees in this industry and disinclination towards the adoption of healthcare fraud analytics in developing countries, are the main determinants hindering the growth of healthcare fraud detection market. On the other hand, the increasing usage of software for fraud detection in the healthcare industry and evolving machine learning technique, are expected to render lucrative opportunities to the market players during the upcoming years.

    The report provides detailed qualitative and quantitative analysis of the global healthcare fraud detection market. Market size and forecast in terms of value has been provided for the period – (2017 – 2025), for the segments type, application, delivery model, component, end user and in each of the major regions.

    Healthcare Fraud Detection Market Segmentation

    By Type
    • Predictive Analytics
    • Descriptive Analytics
    • Prescriptive Analytics

    By Application
    • Insurance claims review
    • Payment integrity
    • Others

    By Delivery model
    • On-premise
    • On-demand

    By Component
    • Services
    • Software

    By End user
    • Employers
    • Private insurance payers
    • Third party service providers
    • Public/government agencies

    By Geography

    • North America
    o U.S.
    o Canada
    o Mexico

    • Europe
    o U.K.
    o France
    o Germany
    o Italy
    o Spain
    o Rest of Europe

    • Asia-Pacific
    o China
    o Japan
    o India
    o Korea
    o Rest of APAC

    • South America
    o Brazil
    o Rest of South America

    • Rest of the World
    o Middle East
    o Africa

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  • CHAPTER 1. INTRODUCTION
    1.1. RESEARCH METHODOLOGY
    1.1.1. ERC desk research
    1.1.2. ERC data synthesis
    1.1.3. Data validation and market feedback
    1.1.4. ERC data sources

    CHAPTER 2. HEALTHCARE FRAUD DETECTION MARKET OVERVIEW
    2.1. HEALTHCARE FRAUD DETECTION MARKET INTRODUCTION
    2.2. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE AND GROWTH RATE, 2017-2025
    2.2.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Growth Rate (%), (2017-2025)

    CHAPTER 3. GLOBAL HEALTHCARE FRAUD DETECTION MARKET BY TYPE, 2017-2025
    3.1. PREDICTIVE ANALYTICS
    3.2. DESCRIPTIVE ANALYTICS
    3.3. PRESCRIPTIVE ANALYTICS
    3.4. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE BY TYPE, 2017-2025
    3.4.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Share (%) By Type, 2017-2025
    3.4.2. Predictive Analytics Market Revenue and Growth Rate, 2017-2025
    3.4.3. Descriptive Analytics Market Revenue and Growth Rate, 2017-2025
    3.4.4. Prescriptive Analytics Market Revenue and Growth Rate, 2017-2025

    Note: Similar information coverage has been provided for delivery model segment.

    CHAPTER 4. GLOBAL HEALTHCARE FRAUD DETECTION MARKET BY APPLICATION, 2017-2025
    4.1. INSURANCE CLAIMS REVIEW
    4.2. PAYMENT INTEGRITY
    4.3. OTHERS
    4.4. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE BY APPLICATION, 2017-2025
    4.4.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Share (%) By Application, 2017-2025
    4.4.2. Insurance claims review Market Revenue and Growth Rate, 2017-2025
    4.4.3. Payment integrity Market Revenue and Growth Rate, 2017-2025
    4.4.4. Others Market Revenue and Growth Rate, 2017-2025

    Note: Similar information coverage has been provided for component and end-user segment.

    CHAPTER 5. GLOBAL HEALTHCARE FRAUD DETECTION MARKET BY REGION, 2017-2025
    5.1. NORTH AMERICA
    5.1.1. U.S.
    5.1.2. Canada
    5.1.3. Mexico
    5.2. EUROPE
    5.2.1. U.K.
    5.2.2. France
    5.2.3. Germany
    5.2.4. Italy
    5.2.5. Spain
    5.2.6. Rest of Europe
    5.3. ASIA PACIFIC
    5.3.1. China
    5.3.2. Japan
    5.3.3. India
    5.3.4. Korea
    5.3.5. Rest of APAC
    5.4. SOUTH AMERICA
    5.4.1. Brazil
    5.4.2. Rest of South America
    5.5. REST OF THE WORLD
    5.5.1. Middle East
    5.5.2. Africa
    5.6. GLOBAL HEALTHCARE FRAUD DETECTION MARKET REVENUE BY REGION, 2017-2025
    5.6.1. Global Healthcare Fraud Detection Market Revenue (Million USD) and Share (%) By Region, 2017-2025
    5.6.2. North America Market Revenue and Growth Rate, 2017-2025
    5.6.3. Europe Market Revenue and Growth Rate, 2017-2025
    5.6.4. Asia Pacific Market Revenue and Growth Rate, 2017-2025
    5.6.5. South America Market Revenue and Growth Rate, 2017-2025
    5.6.6. Rest of the World Market Revenue and Growth Rate, 2017-2025

    CHAPTER 6. MARKET DETERMINANTS
    6.1. MARKET DRIVERS
    6.2. MARKET RESTRAINTS
    6.3. MARKET OPPORTUNITIES
    6.4. MARKET DETERMINANTS RADAR CHART

    CHAPTER 7. GLOBAL HEALTHCARE FRAUD DETECTION MARKET COMPETITION BY SERVICE PROVIDERS
    7.1. GLOBAL HEALTHCARE FRAUD DETECTION REVENUE AND SHARE BY SERVICE PROVIDERS (2017-2025)
    7.1.1. Global Healthcare Fraud Detection Revenue (Million USD) and Share (%) by Service Providers (2017-2025)
    7.2. HEALTHCARE FRAUD DETECTION MARKET COMPETITIVE SITUATION AND TRENDS
    7.2.1. Healthcare Fraud Detection Market Share (%) of Top 3 Service Providers
    7.2.2. Healthcare Fraud Detection Market Share (%) of Top 5 Service Providers

    CHAPTER 8. COMPANY PROFILES
    8.1. OPTUM
    8.1.1. Business Overview
    8.1.2. Company Basic Information
    8.1.3. Healthcare Fraud Detection Product Details
    8.1.4. Optum Healthcare Fraud Detection Revenue and Gross Margin
    8.2. SAS
    8.2.1. Business Overview
    8.2.2. Company Basic Information
    8.2.3. Healthcare Fraud Detection Product Details
    8.2.4. SAS Healthcare Fraud Detection Revenue and Gross Margin
    8.3. SCIO
    8.3.1. Business Overview
    8.3.2. Company Basic Information
    8.3.3. Healthcare Fraud Detection Product Details
    8.3.4. SCIO Healthcare Fraud Detection Revenue and Gross Margin
    8.4. VERSCEND
    8.4.1. Business Overview
    8.4.2. Company Basic Information
    8.4.3. Healthcare Fraud Detection Product Details
    8.4.4. Verscend Healthcare Fraud Detection Revenue and Gross Margin
    8.5. HCL
    8.5.1. Business Overview
    8.5.2. Company Basic Information
    8.5.3. Healthcare Fraud Detection Product Details
    8.5.4. HCL Healthcare Fraud Detection Revenue and Gross Margin
    8.6. DXC
    8.6.1. Business Overview
    8.6.2. Company Basic Information
    8.6.3. Healthcare Fraud Detection Product Details
    8.6.4. DXC Healthcare Fraud Detection Revenue and Gross Margin
    8.7. LEXISNEXIS
    8.7.1. Business Overview
    8.7.2. Company Basic Information
    8.7.3. Healthcare Fraud Detection Product Details
    8.7.4. LexisNexis Healthcare Fraud Detection Revenue and Gross Margin
    8.8. IBM
    8.8.1. Business Overview
    8.8.2. Company Basic Information
    8.8.3. Healthcare Fraud Detection Product Details
    8.8.4. IBM Healthcare Fraud Detection Revenue and Gross Margin
    8.9. NORTHROP GRUMMAN
    8.9.1. Business Overview
    8.9.2. Company Basic Information
    8.9.3. Healthcare Fraud Detection Product Details
    8.9.4. Northrop Grumman Healthcare Fraud Detection Revenue and Gross Margin
    8.10. PONDERA
    8.10.1. Business Overview
    8.10.2. Company Basic Information
    8.10.3. Healthcare Fraud Detection Product Details
    8.10.4. Pondera Healthcare Fraud Detection Revenue and Gross Margin

    CHAPTER 9. HEALTHCARE FRAUD DETECTION MARKET VALUE CHAIN ANALYSIS
    9.1. HEALTHCARE FRAUD DETECTION INDUSTRIAL CHAIN ANALYSIS
    9.2. CONSUMER ANALYSIS
    9.2.1. Consumer 1
    9.2.2. Consumer 2
    9.2.3. Consumer 3
    9.2.4. Consumer 4

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  • • Optum
    • SAS
    • SCIO
    • McKesson
    • Verscend
    • Conduent
    • Wipro
    • HCL
    • DXC
    • CGI
    • LexisNexis
    • Northrop Grumman
    • IBM
    • Pondera

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What Information does this report contain?

• What was the market size of the Healthcare Fraud Detection Market in 2017 and the expected market size by 2025, along with the growth rate?
• An in-depth analysis of the current impacting factors, opportunities and challenges/restraints in the market
• Which are the largest revenue generating products, services or regions and their comparative growth rate?
• Which technology is in trend and how would it evolve during the forecast period (2017 – 2025)?
• Which are the leading companies in the Healthcare Fraud Detection Market and their competitive positioning basis their market share, product portfolio, strategic attempts and business focus?

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