Global Healthcare Fraud Detection Market (2022 to 2027) - Industry Trends, Share, Size, Growth, Opportunity and Forecasts

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Jul 11, 2022, 12:00 ET

DUBLIN, July 11, 2022 /PRNewswire/ -- The "Healthcare Fraud Detection Market: Global Industry Trends, Share, Size, Growth, Opportunity and Forecast 2022-2027" report has been added to ResearchAndMarkets.com's offering.

The global healthcare fraud detection market reached a value of US$ 1.58 Billion in 2021. Looking forward, the publisher expects the market to reach a value of US$ 6.44 Billion by 2027, exhibiting a CAGR of 26.39% during 2021-2027. Keeping in mind the uncertainties of COVID-19, we are continuously tracking and evaluating the direct as well as the indirect influence of the pandemic on different end use sectors. These insights are included in the report as a major market contributor.

Healthcare fraud detection aids in detecting and preventing healthcare fraud, waste, and abuse at every stage of the claim process and reducing inappropriate payments. It connects existing payment integrity solutions and consolidates data from internal and external sources, such as claims systems, watch lists, third parties, and unstructured texts for efficient data management.

It relies on various advanced analytic and artificial learning (AI) techniques, including modern statistical, machine learning (ML), deep learning, and text analytics algorithms. Apart from this, it uses a flexible process to assist operational, clinical, and investigative evaluations and store all relevant case information.

Due to an increase in the number of patients seeking health insurance, there is a rise in the demand for healthcare fraud detection solutions. This, along with the growing prepayment review model in the healthcare industry, represents one of the key factors driving the market.

Moreover, the increasing number of pharmacy claims-related frauds across the globe is propelling the growth of the market. In addition, there is a rise in the demand for solutions that have biometric sensors to identify frauds. This, coupled with the growing adoption of healthcare fraud analytics, especially in developing countries, is positively influencing the market. Besides this, the increasing integration of artificial intelligence (AI) in healthcare fraud detection is offering lucrative growth opportunities to industry investors.

Apart from this, governments of several countries are undertaking initiatives to review healthcare insurance claims and save money of consumers and nations. In line with this, the burgeoning healthcare industry is bolstering the growth of the market. Other growth-inducing factors are the increasing returns on investment (ROI), rising use of social media, and funding for the implementation of several information and technology (IT) platforms.

Competitive Landscape:

The competitive landscape of the industry has also been examined along with the profiles of the key players being CGI Inc., Conduent Inc., ExlService Holdings Inc., Fair Isaac Corporation, HCL Technologies Limited, International Business Machines Corporation, Northrop Grumman Corporation, RELX Group plc, SAS Institute Inc., UnitedHealth Group and Wipro Ltd.

Key Questions Answered in This Report:

How has the global healthcare fraud detection market performed so far and how will it perform in the coming years?
What has been the impact of COVID-19 on the global healthcare fraud detection market?
What are the key regional markets?
What is the breakup of the market based on the component?
What is the breakup of the market based on the type?
What is the breakup of the market based on the delivery mode?
What is the breakup of the market based on the application?
What is the breakup of the market based on the end user?
What are the various stages in the value chain of the industry?
What are the key driving factors and challenges in the industry?
What is the structure of the global healthcare fraud detection market and who are the key players?
What is the degree of competition in the industry?

Key Topics Covered:

1 Preface

2 Scope and Methodology
2.1 Objectives of the Study
2.2 Stakeholders
2.3 Data Sources
2.3.1 Primary Sources
2.3.2 Secondary Sources
2.4 Market Estimation
2.4.1 Bottom-Up Approach
2.4.2 Top-Down Approach
2.5 Forecasting Methodology

3 Executive Summary

4 Introduction
4.1 Overview
4.2 Key Industry Trends

5 Global Healthcare Fraud Detection Market
5.1 Market Overview
5.2 Market Performance
5.3 Impact of COVID-19
5.4 Market Forecast

6 Market Breakup by Component
6.1 Software
6.1.1 Market Trends
6.1.2 Market Forecast
6.2 Services
6.2.1 Market Trends
6.2.2 Market Forecast

7 Market Breakup by Type
7.1 Descriptive Analytics
7.1.1 Market Trends
7.1.2 Market Forecast
7.2 Predictive Analytics
7.2.1 Market Trends
7.2.2 Market Forecast
7.3 Prescriptive Analytics
7.3.1 Market Trends
7.3.2 Market Forecast

8 Market Breakup by Delivery Mode
8.1 On-premises
8.1.1 Market Trends
8.1.2 Market Forecast
8.2 On-demand
8.2.1 Market Trends
8.2.2 Market Forecast

9 Market Breakup by Application
9.1 Insurance Claims Review
9.1.1 Market Trends
9.1.2 Market Forecast
9.2 Payment Integrity
9.2.1 Market Trends
9.2.2 Market Forecast

10 Market Breakup by End User
10.1 Private Insurance Payers
10.1.1 Market Trends
10.1.2 Market Forecast
10.2 Government Agencies
10.2.1 Market Trends
10.2.2 Market Forecast
10.3 Others
10.3.1 Market Trends
10.3.2 Market Forecast

11 Market Breakup by Region

12 SWOT Analysis

13 Value Chain Analysis

14 Porters Five Forces Analysis

15 Price Analysis

16 Competitive Landscape
16.1 Market Structure
16.2 Key Players
16.3 Profiles of Key Players
16.3.1 CGI Inc.
16.3.1.1 Company Overview
16.3.1.2 Product Portfolio
16.3.1.3 Financials
16.3.1.4 SWOT Analysis
16.3.2 Conduent Inc.
16.3.2.1 Company Overview
16.3.2.2 Product Portfolio
16.3.2.3 Financials
16.3.2.4 SWOT Analysis
16.3.3 ExlService Holdings Inc.
16.3.3.1 Company Overview
16.3.3.2 Product Portfolio
16.3.3.3 Financials
16.3.4 Fair Isaac Corporation
16.3.4.1 Company Overview
16.3.4.2 Product Portfolio
16.3.4.3 Financials
16.3.4.4 SWOT Analysis
16.3.5 HCL Technologies Limited
16.3.5.1 Company Overview
16.3.5.2 Product Portfolio
16.3.5.3 Financials
16.3.5.4 SWOT Analysis
16.3.6 International Business Machines Corporation
16.3.6.1 Company Overview
16.3.6.2 Product Portfolio
16.3.6.3 Financials
16.3.7 Northrop Grumman Corporation
16.3.7.1 Company Overview
16.3.7.2 Product Portfolio
16.3.7.3 Financials
16.3.7.4 SWOT Analysis
16.3.8 RELX Group plc
16.3.8.1 Company Overview
16.3.8.2 Product Portfolio
16.3.8.3 Financials
16.3.8.4 SWOT Analysis
16.3.9 SAS Institute Inc.
16.3.9.1 Company Overview
16.3.9.2 Product Portfolio
16.3.9.3 SWOT Analysis
16.3.10 UnitedHealth Group
16.3.10.1 Company Overview
16.3.10.2 Product Portfolio
16.3.10.3 Financials
16.3.10.4 SWOT Analysis
16.3.11 Wipro Ltd.
16.3.11.1 Company Overview
16.3.11.2 Product Portfolio
16.3.11.3 Financials