Healthcare Fraud Detection Market By type (Predictive Analytics, Descriptive Analytics, Prescriptive Analytics), By application (Insurance claims review, Payment integrity), By delivery model (On-premises, On-demand), By component (Services, Software), By end user (Employers, Private insurance payers, Third party service providers, Public/government agencies), Industry Analysis, COVID-19 Impact Analysis, Size, Share, Growth, Trends, and Forecasts 2021-2028

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The global Healthcare Fraud Detection market size is estimated at 8.7 billion USD with a CAGR of 29.9% during the forecasted period from 2021-2028.
  • Market Overview:

    The global Healthcare Fraud Detection market size is estimated at 8.7 billion USD with a CAGR of 29.9% during the forecasted period from 2021-2028.

    A criminal deception intended to result in financial gain during drug manufacturing, quality of the product, medical practice, and health insurance is defined as Healthcare Fraud. The global Healthcare Fraud Detection market is expected to show high growth rate due to adoption of data mining practices.

    The key factor driving the growth of Healthcare Fraud Detection market is attributed to growing number of fraudulent events in health care.Also, rising number of patients choosing health insurance is positively influencing the market growth.

    Moreover, measures to decrease healthcare spending along with increasing pressure to uplift the operational efficacy is fostering the market growth during the forecast period. Furthermore, factors such as increase in healthcare BPO and efficacy of artificial intelligence in healthcare services & solutions are surging the market size.

    On the other hand, factors such as dearth of skilled professionals and high cost of detection software & services can limit the growth of Healthcare Fraud Detection market. Also, lack of awareness and low implementation rate in emerging economies is projected to hamper the growth of this market.

    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 2021 and the expected market size by 2028, 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 (2021 – 2028)?
    • 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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