MARKET OVERVIEW
Healthcare fraud is difficult to detect and generally goes unnoticed; therefore, detecting such fraudulent claims is necessary, as they increase the burden on society. The use of fraud detection solutions enables healthcare firms in accounting and auditing by predictive data methodologies. Careful account auditing can reveal suspicious providers and policyholders and detect potential fraudulent cases before it occurs.
MARKET SCOPE
The "Global Healthcare Fraud Detection Market Analysis to 2031" is a specialized and in-depth study of the food and beverages industry with a special focus on the global market trend analysis. The report aims to provide an overview of the healthcare fraud detection market with detailed market segmentation by delivery model, component, type, application, end user, and geography. The report provides key statistics on the market status of the leading healthcare fraud detection market players and offers key trends and opportunities in the market.
MARKET SEGMENTATION
- Based on delivery model, the global healthcare fraud detection market is segmented into on-premise, and cloud-based.
- Based on component, the market is bifurcated into services, and software.
- Based on type, the market is bifurcated into predictive analytics, prescriptive analytics, and descriptive analytics.
- Based on application, the market is bifurcated into insurance claims review, payment integrity.
- Based on end user, the global healthcare fraud detection market is segmented into public or government agencies, private insurance payers, and private insurance payers.
MARKET DYNAMICS
Drivers
- Increasing number of fraudulent activities in healthcare
- Rising number of patients opting health insurance
- Increasing pressure of fraud and abuse on healthcare
Restraints
- The data security concerns in the healthcare industry are expected to restraint the growth of market.
REGIONAL FRAMEWORK
The report provides a detailed overview of the industry including both qualitative and quantitative information. It provides an overview and forecast of the global market based on various segments. It also provides market size and forecast estimates from the year 2021 to 2031 with respect to five major regions, namely; North America, Europe, Asia-Pacific (APAC), the Middle East and Africa (MEA), and South America. The healthcare fraud detection market by each region is later sub-segmented by respective countries and segments. The report covers the analysis and forecast of 18 countries globally along with the current trend and opportunities prevailing in the region.
The report analyzes factors affecting the market from both demand and supply side and further evaluates market dynamics affecting the marketduring the forecast period i.e., drivers, restraints, opportunities, and future trend. The report also provides exhaustive PEST analysis for all five regions namely; North America, Europe, APAC, MEA, and South America after evaluating political, economic, social and technological factors affecting the healthcare fraud detection market in these regions.
IMPACT OF COVID-19 ON HEALTHCARE FRAUD DETECTION MARKET
COVID-19 pandemic has offered significant growth opportunities to healthcare fraud detection across the world. The limited medical services due to social distancing and implementation of quarantine around the globe have leveraged the telemedicine industry. As a result, it has increased demand for online medical services such as second opinion, tele consulting, and mHealth. Hence there is an increase in the use of healthcare information technology. The increase in online services has also leveraged the fraud cases in the industry. Therefore it is expected that the COVID-19 pandemic has served vital growth opportunities for the market.
MARKET PLAYERS
The report covers key developments in the healthcare fraud detection market as organic and inorganic growth strategies. Various companies are focusing on organic growth strategies such as product launches, product approvals and others such as patents and events. Inorganic growth strategies activities witnessed in the marketwere acquisitions, and partnership & collaborations. These activities have paved way for the expansion of business and customer base of market players. The market payers from healthcare fraud detection market are anticipated to lucrative growth opportunities in the future with the rising demand for healthcare fraud detection in the global market.
The report also includes the profiles of key companies along with their SWOT analysis and market strategies in the healthcare fraud detection market. In addition, the report focuses on leading industry players with information such as company profiles, components, and services offered, financial information of the last 3 years, the key development in the past five years.
- Scio Health Analytics
- Northrop Grumman
- SAS Institute Inc
- OSP Labs
- Wipro Limited
- IBM
- Relx Group PLC (LexisNexis)
- HCL Technologies
- CGI Group Inc
- DXC Technology Company
The Insight Partner's dedicated research and analysis team consist of experienced professionals with advanced statistical expertise and offer various customization options in the existing study.
Healthcare Fraud Detection Report Scope
Report Attribute | Details |
---|---|
Market size in 2024 | US$ XX million |
Market Size by 2031 | US$ XX Million |
Global CAGR (2025 - 2031) | XX% |
Historical Data | 2021-2023 |
Forecast period | 2025-2031 |
Segments Covered |
By Delivery Model
|
Regions and Countries Covered | North America
|
Market leaders and key company profiles |
- Historical Analysis (2 Years), Base Year, Forecast (7 Years) with CAGR
- PEST and SWOT Analysis
- Market Size Value / Volume - Global, Regional, Country
- Industry and Competitive Landscape
- Excel Dataset
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Testimonials
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- Identifying Emerging Markets
- Customer Insights
- Market Forecasts
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- Boosting Operational Efficiency
- Strategic Planning
- Investment Justification
- Tracking Industry Innovations
- Aligning with Regulatory Trends
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1. Scio Health Analytics
2. Northrop Grumman
3. SAS Institute Inc
4. OSP Labs
5. Wipro Limited
6. IBM
7. Relx Group PLC (LexisNexis)
8. HCL Technologies
9. CGI Group Inc
10. DXC Technology Company
11. Cotiviti Holdings, Inc.
12. Fair Isaac Corporation
13. Mckesson Corporation
14. Healthcare Fraud Shield
15. FraudLens, Inc.


