Healthcare Fraud Detection Market Forecast to 2027 - Covid-19 Impact and Global Analysis - By Delivery Model (On-Premise Delivery Models, On-Demand Delivery Models); Component (Services, Software); Type (Predictive Analytics, Prescriptive Analytics, Descriptive Analytics); Application (Insurance Claims Review, Payment Integrity, Other Applications); End-User (Public or Government Agencies, Private Insurance Payers, Private Insurance Payers, Employers) and Geography
Healthcare fraud is difficult to detect and is generally go unnoticed; therefore, detection of such fraudulent claims is necessary, as they increase the burden on society. The use of fraud detection solution 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 DYNAMICS
Large number of fraudulent activities in healthcare, rising number of patients opting health insurance, prepayment review model, increasing pressure of fraud and abuse on healthcare spending is expected to drive the growth of the market. Moreover, increasing adoption of cloud-based analytics, emergence of social media and its impact on the healthcare industry, artificial intelligence (AI) in healthcare fraud detection is expected to provide opportunity for the growth of healthcare fraud detection market during the forecast period
MARKET SCOPE
The "Global Healthcare Fraud Detection Market Analysis to 2027" is a specialized and in-depth study of the healthcare fraud detection industry with a focus on the global market trend. The report aims to provide an overview of global healthcare fraud detection market with detailed market segmentation by delivery model, component, type, application, end user, and geography. The global healthcare fraud detection market is expected to witness high growth during the forecast period. The report provides key statistics on the market status of the leading market players and offers key trends and opportunities in the market.
MARKET SEGMENTATION
The healthcare fraud detection market is segmented based on delivery model as, on-premise delivery models and on-premise delivery models. On the basis of component healthcare fraud detection market is segmented into services and software. Based on type, healthcare fraud detection market is segmented into predictive analytics, prescriptive analytics and descriptive analytics. On the basis of application, healthcare fraud detection market is segmented into insurance claims review, payment integrity and other applications. Based on the end user the market is segmented as public/government agencies, private insurance payers, third-party service providers and employers.
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REGIONAL FRAMEWORKThe report provides a detailed overview of the industry including both qualitative and quantitative information. It provides overview and forecast of the global healthcare fraud detection market based on various segments. It also provides market size and forecast estimates from year 2017 to 2027 with respect to five major regions, namely; North America, Europe, Asia-Pacific (APAC), Middle East and Africa (MEA) and South & Central America. The healthcare fraud detection market by each region is later sub-segmented by respective countries and segments. The report covers analysis and forecast of 18 countries globally along with current trend and opportunities prevailing in the region.
The report analyzes factors affecting healthcare fraud detection market from both demand and supply side and further evaluates market dynamics effecting the market during 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 & Central America after evaluating political, economic, social and technological factors effecting the healthcare fraud detection market in these regions.
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MARKET PLAYERS
The reports cover 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 market were acquisitions, and partnership & collaborations. These activities have paved way for expansion of business and customer base of market players. The market players from healthcare fraud detection market are anticipated to lucrative growth opportunities in the future with the rising demand for healthcare fraud detection market in the global market. Below mentioned is the list of few companies engaged in the healthcare fraud detection market.
The report also includes the profiles of key healthcare fraud detection market companies along with their SWOT analysis and market strategies. In addition, the report focuses on leading industry players with information such as company profiles, components and services offered, financial information of last 3 years, key development in past five years.
1. Verscend Technologies, Inc
2. Fair Isaac Corporation
3. SAS Institute Inc
4. SCIOInspire, Corp
5. Wipro Limited
6. IBM
7. Conduent, Inc
8. HCL Technologies Limited
9. CGI Group Inc
10. McKesson Corporation
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.
TABLE OF CONTENTS
1. INTRODUCTION
1.1. SCOPE OF THE STUDY
1.2. THE INSIGHT PARTNERS RESEARCH REPORT GUIDANCE
1.3. MARKET SEGMENTATION
1.3.1 Healthcare Fraud Detection Market - By Delivery Model
1.3.2 Healthcare Fraud Detection Market - By Component
1.3.3 Healthcare Fraud Detection Market - By Type
1.3.4 Healthcare Fraud Detection Market - By Application
1.3.5 Healthcare Fraud Detection Market - By End-User
1.3.6 Healthcare Fraud Detection Market - By Region
1.3.6.1 By Country
2. KEY TAKEAWAYS
3. RESEARCH METHODOLOGY
4. HEALTHCARE FRAUD DETECTION MARKET LANDSCAPE
4.1. OVERVIEW
4.2. PEST ANALYSIS
4.2.1 North America - Pest Analysis
4.2.2 Europe - Pest Analysis
4.2.3 Asia-Pacific - Pest Analysis
4.2.4 Middle East and Africa - Pest Analysis
4.2.5 South and Central America - Pest Analysis
4.3. EXPERT OPINIONS
5. HEALTHCARE FRAUD DETECTION MARKET - KEY MARKET DYNAMICS
5.1. KEY MARKET DRIVERS
5.2. KEY MARKET RESTRAINTS
5.3. KEY MARKET OPPORTUNITIES
5.4. FUTURE TRENDS
5.5. IMPACT ANALYSIS OF DRIVERS, RESTRAINTS & EXPECTED INFLUENCE OF COVID-19 PANDEMIC
6. HEALTHCARE FRAUD DETECTION MARKET - GLOBAL MARKET ANALYSIS
6.1. HEALTHCARE FRAUD DETECTION - GLOBAL MARKET OVERVIEW
6.2. HEALTHCARE FRAUD DETECTION - GLOBAL MARKET AND FORECAST TO 2027
6.3. MARKET POSITIONING/MARKET SHARE
7. HEALTHCARE FRAUD DETECTION MARKET - REVENUE AND FORECASTS TO 2027 - DELIVERY MODEL
7.1. OVERVIEW
7.2. DELIVERY MODEL MARKET FORECASTS AND ANALYSIS
7.3. ON-PREMISE DELIVERY MODELS
7.3.1. Overview
7.3.2. On-Premise Delivery Models Market Forecast and Analysis
7.4. ON-DEMAND DELIVERY MODELS
7.4.1. Overview
7.4.2. On-Demand Delivery Models Market Forecast and Analysis
8. HEALTHCARE FRAUD DETECTION MARKET - REVENUE AND FORECASTS TO 2027 - COMPONENT
8.1. OVERVIEW
8.2. COMPONENT MARKET FORECASTS AND ANALYSIS
8.3. SERVICES
8.3.1. Overview
8.3.2. Services Market Forecast and Analysis
8.4. SOFTWARE
8.4.1. Overview
8.4.2. Software Market Forecast and Analysis
9. HEALTHCARE FRAUD DETECTION MARKET - REVENUE AND FORECASTS TO 2027 - TYPE
9.1. OVERVIEW
9.2. TYPE MARKET FORECASTS AND ANALYSIS
9.3. PREDICTIVE ANALYTICS
9.3.1. Overview
9.3.2. Predictive Analytics Market Forecast and Analysis
9.4. PRESCRIPTIVE ANALYTICS
9.4.1. Overview
9.4.2. Prescriptive Analytics Market Forecast and Analysis
9.5. DESCRIPTIVE ANALYTICS
9.5.1. Overview
9.5.2. Descriptive Analytics Market Forecast and Analysis
10. HEALTHCARE FRAUD DETECTION MARKET - REVENUE AND FORECASTS TO 2027 - APPLICATION
10.1. OVERVIEW
10.2. APPLICATION MARKET FORECASTS AND ANALYSIS
10.3. INSURANCE CLAIMS REVIEW
10.3.1. Overview
10.3.2. Insurance Claims Review Market Forecast and Analysis
10.4. PAYMENT INTEGRITY
10.4.1. Overview
10.4.2. Payment Integrity Market Forecast and Analysis
10.5. OTHER APPLICATIONS
10.5.1. Overview
10.5.2. Other Applications Market Forecast and Analysis
11. HEALTHCARE FRAUD DETECTION MARKET - REVENUE AND FORECASTS TO 2027 - END-USER
11.1. OVERVIEW
11.2. END-USER MARKET FORECASTS AND ANALYSIS
11.3. PUBLIC OR GOVERNMENT AGENCIES
11.3.1. Overview
11.3.2. Public or Government Agencies Market Forecast and Analysis
11.4. PRIVATE INSURANCE PAYERS
11.4.1. Overview
11.4.2. Private Insurance Payers Market Forecast and Analysis
11.5. PRIVATE INSURANCE PAYERS
11.5.1. Overview
11.5.2. Private Insurance Payers Market Forecast and Analysis
11.6. EMPLOYERS
11.6.1. Overview
11.6.2. Employers Market Forecast and Analysis
12. HEALTHCARE FRAUD DETECTION MARKET REVENUE AND FORECASTS TO 2027 - GEOGRAPHICAL ANALYSIS
12.1. NORTH AMERICA
12.1.1 North America Healthcare Fraud Detection Market Overview
12.1.2 North America Healthcare Fraud Detection Market Forecasts and Analysis
12.1.3 North America Healthcare Fraud Detection Market Forecasts and Analysis - By Delivery Model
12.1.4 North America Healthcare Fraud Detection Market Forecasts and Analysis - By Component
12.1.5 North America Healthcare Fraud Detection Market Forecasts and Analysis - By Type
12.1.6 North America Healthcare Fraud Detection Market Forecasts and Analysis - By Application
12.1.7 North America Healthcare Fraud Detection Market Forecasts and Analysis - By End-User
12.1.8 North America Healthcare Fraud Detection Market Forecasts and Analysis - By Countries
12.1.8.1 United States Healthcare Fraud Detection Market
12.1.8.1.1 United States Healthcare Fraud Detection Market by Delivery Model
12.1.8.1.2 United States Healthcare Fraud Detection Market by Component
12.1.8.1.3 United States Healthcare Fraud Detection Market by Type
12.1.8.1.4 United States Healthcare Fraud Detection Market by Application
12.1.8.1.5 United States Healthcare Fraud Detection Market by End-User
12.1.8.2 Canada Healthcare Fraud Detection Market
12.1.8.2.1 Canada Healthcare Fraud Detection Market by Delivery Model
12.1.8.2.2 Canada Healthcare Fraud Detection Market by Component
12.1.8.2.3 Canada Healthcare Fraud Detection Market by Type
12.1.8.2.4 Canada Healthcare Fraud Detection Market by Application
12.1.8.2.5 Canada Healthcare Fraud Detection Market by End-User
12.1.8.3 Mexico Healthcare Fraud Detection Market
12.1.8.3.1 Mexico Healthcare Fraud Detection Market by Delivery Model
12.1.8.3.2 Mexico Healthcare Fraud Detection Market by Component
12.1.8.3.3 Mexico Healthcare Fraud Detection Market by Type
12.1.8.3.4 Mexico Healthcare Fraud Detection Market by Application
12.1.8.3.5 Mexico Healthcare Fraud Detection Market by End-User
12.2. EUROPE
12.2.1 Europe Healthcare Fraud Detection Market Overview
12.2.2 Europe Healthcare Fraud Detection Market Forecasts and Analysis
12.2.3 Europe Healthcare Fraud Detection Market Forecasts and Analysis - By Delivery Model
12.2.4 Europe Healthcare Fraud Detection Market Forecasts and Analysis - By Component
12.2.5 Europe Healthcare Fraud Detection Market Forecasts and Analysis - By Type
12.2.6 Europe Healthcare Fraud Detection Market Forecasts and Analysis - By Application
12.2.7 Europe Healthcare Fraud Detection Market Forecasts and Analysis - By End-User
12.2.8 Europe Healthcare Fraud Detection Market Forecasts and Analysis - By Countries
12.2.8.1 Germany Healthcare Fraud Detection Market
12.2.8.1.1 Germany Healthcare Fraud Detection Market by Delivery Model
12.2.8.1.2 Germany Healthcare Fraud Detection Market by Component
12.2.8.1.3 Germany Healthcare Fraud Detection Market by Type
12.2.8.1.4 Germany Healthcare Fraud Detection Market by Application
12.2.8.1.5 Germany Healthcare Fraud Detection Market by End-User
12.2.8.2 France Healthcare Fraud Detection Market
12.2.8.2.1 France Healthcare Fraud Detection Market by Delivery Model
12.2.8.2.2 France Healthcare Fraud Detection Market by Component
12.2.8.2.3 France Healthcare Fraud Detection Market by Type
12.2.8.2.4 France Healthcare Fraud Detection Market by Application
12.2.8.2.5 France Healthcare Fraud Detection Market by End-User
12.2.8.3 Italy Healthcare Fraud Detection Market
12.2.8.3.1 Italy Healthcare Fraud Detection Market by Delivery Model
12.2.8.3.2 Italy Healthcare Fraud Detection Market by Component
12.2.8.3.3 Italy Healthcare Fraud Detection Market by Type
12.2.8.3.4 Italy Healthcare Fraud Detection Market by Application
12.2.8.3.5 Italy Healthcare Fraud Detection Market by End-User
12.2.8.4 Spain Healthcare Fraud Detection Market
12.2.8.4.1 Spain Healthcare Fraud Detection Market by Delivery Model
12.2.8.4.2 Spain Healthcare Fraud Detection Market by Component
12.2.8.4.3 Spain Healthcare Fraud Detection Market by Type
12.2.8.4.4 Spain Healthcare Fraud Detection Market by Application
12.2.8.4.5 Spain Healthcare Fraud Detection Market by End-User
12.2.8.5 United Kingdom Healthcare Fraud Detection Market
12.2.8.5.1 United Kingdom Healthcare Fraud Detection Market by Delivery Model
12.2.8.5.2 United Kingdom Healthcare Fraud Detection Market by Component
12.2.8.5.3 United Kingdom Healthcare Fraud Detection Market by Type
12.2.8.5.4 United Kingdom Healthcare Fraud Detection Market by Application
12.2.8.5.5 United Kingdom Healthcare Fraud Detection Market by End-User
12.3. ASIA-PACIFIC
12.3.1 Asia-Pacific Healthcare Fraud Detection Market Overview
12.3.2 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis
12.3.3 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis - By Delivery Model
12.3.4 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis - By Component
12.3.5 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis - By Type
12.3.6 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis - By Application
12.3.7 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis - By End-User
12.3.8 Asia-Pacific Healthcare Fraud Detection Market Forecasts and Analysis - By Countries
12.3.8.1 Australia Healthcare Fraud Detection Market
12.3.8.1.1 Australia Healthcare Fraud Detection Market by Delivery Model
12.3.8.1.2 Australia Healthcare Fraud Detection Market by Component
12.3.8.1.3 Australia Healthcare Fraud Detection Market by Type
12.3.8.1.4 Australia Healthcare Fraud Detection Market by Application
12.3.8.1.5 Australia Healthcare Fraud Detection Market by End-User
12.3.8.2 China Healthcare Fraud Detection Market
12.3.8.2.1 China Healthcare Fraud Detection Market by Delivery Model
12.3.8.2.2 China Healthcare Fraud Detection Market by Component
12.3.8.2.3 China Healthcare Fraud Detection Market by Type
12.3.8.2.4 China Healthcare Fraud Detection Market by Application
12.3.8.2.5 China Healthcare Fraud Detection Market by End-User
12.3.8.3 India Healthcare Fraud Detection Market
12.3.8.3.1 India Healthcare Fraud Detection Market by Delivery Model
12.3.8.3.2 India Healthcare Fraud Detection Market by Component
12.3.8.3.3 India Healthcare Fraud Detection Market by Type
12.3.8.3.4 India Healthcare Fraud Detection Market by Application
12.3.8.3.5 India Healthcare Fraud Detection Market by End-User
12.3.8.4 Japan Healthcare Fraud Detection Market
12.3.8.4.1 Japan Healthcare Fraud Detection Market by Delivery Model
12.3.8.4.2 Japan Healthcare Fraud Detection Market by Component
12.3.8.4.3 Japan Healthcare Fraud Detection Market by Type
12.3.8.4.4 Japan Healthcare Fraud Detection Market by Application
12.3.8.4.5 Japan Healthcare Fraud Detection Market by End-User
12.3.8.5 South Korea Healthcare Fraud Detection Market
12.3.8.5.1 South Korea Healthcare Fraud Detection Market by Delivery Model
12.3.8.5.2 South Korea Healthcare Fraud Detection Market by Component
12.3.8.5.3 South Korea Healthcare Fraud Detection Market by Type
12.3.8.5.4 South Korea Healthcare Fraud Detection Market by Application
12.3.8.5.5 South Korea Healthcare Fraud Detection Market by End-User
12.4. MIDDLE EAST AND AFRICA
12.4.1 Middle East and Africa Healthcare Fraud Detection Market Overview
12.4.2 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis
12.4.3 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis - By Delivery Model
12.4.4 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis - By Component
12.4.5 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis - By Type
12.4.6 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis - By Application
12.4.7 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis - By End-User
12.4.8 Middle East and Africa Healthcare Fraud Detection Market Forecasts and Analysis - By Countries
12.4.8.1 South Africa Healthcare Fraud Detection Market
12.4.8.1.1 South Africa Healthcare Fraud Detection Market by Delivery Model
12.4.8.1.2 South Africa Healthcare Fraud Detection Market by Component
12.4.8.1.3 South Africa Healthcare Fraud Detection Market by Type
12.4.8.1.4 South Africa Healthcare Fraud Detection Market by Application
12.4.8.1.5 South Africa Healthcare Fraud Detection Market by End-User
12.4.8.2 Saudi Arabia Healthcare Fraud Detection Market
12.4.8.2.1 Saudi Arabia Healthcare Fraud Detection Market by Delivery Model
12.4.8.2.2 Saudi Arabia Healthcare Fraud Detection Market by Component
12.4.8.2.3 Saudi Arabia Healthcare Fraud Detection Market by Type
12.4.8.2.4 Saudi Arabia Healthcare Fraud Detection Market by Application
12.4.8.2.5 Saudi Arabia Healthcare Fraud Detection Market by End-User
12.4.8.3 U.A.E Healthcare Fraud Detection Market
12.4.8.3.1 U.A.E Healthcare Fraud Detection Market by Delivery Model
12.4.8.3.2 U.A.E Healthcare Fraud Detection Market by Component
12.4.8.3.3 U.A.E Healthcare Fraud Detection Market by Type
12.4.8.3.4 U.A.E Healthcare Fraud Detection Market by Application
12.4.8.3.5 U.A.E Healthcare Fraud Detection Market by End-User
12.5. SOUTH AND CENTRAL AMERICA
12.5.1 South and Central America Healthcare Fraud Detection Market Overview
12.5.2 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis
12.5.3 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis - By Delivery Model
12.5.4 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis - By Component
12.5.5 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis - By Type
12.5.6 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis - By Application
12.5.7 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis - By End-User
12.5.8 South and Central America Healthcare Fraud Detection Market Forecasts and Analysis - By Countries
12.5.8.1 Brazil Healthcare Fraud Detection Market
12.5.8.1.1 Brazil Healthcare Fraud Detection Market by Delivery Model
12.5.8.1.2 Brazil Healthcare Fraud Detection Market by Component
12.5.8.1.3 Brazil Healthcare Fraud Detection Market by Type
12.5.8.1.4 Brazil Healthcare Fraud Detection Market by Application
12.5.8.1.5 Brazil Healthcare Fraud Detection Market by End-User
12.5.8.2 Argentina Healthcare Fraud Detection Market
12.5.8.2.1 Argentina Healthcare Fraud Detection Market by Delivery Model
12.5.8.2.2 Argentina Healthcare Fraud Detection Market by Component
12.5.8.2.3 Argentina Healthcare Fraud Detection Market by Type
12.5.8.2.4 Argentina Healthcare Fraud Detection Market by Application
12.5.8.2.5 Argentina Healthcare Fraud Detection Market by End-User
13. INDUSTRY LANDSCAPE
13.1. MERGERS AND ACQUISITIONS
13.2. AGREEMENTS, COLLABORATIONS AND JOIN VENTURES
13.3. NEW PRODUCT LAUNCHES
13.4. EXPANSIONS AND OTHER STRATEGIC DEVELOPMENTS
14. HEALTHCARE FRAUD DETECTION MARKET, KEY COMPANY PROFILES
14.1. VERSCEND TECHNOLOGIES, INC
14.1.1. Key Facts
14.1.2. Business Description
14.1.3. Products and Services
14.1.4. Financial Overview
14.1.5. SWOT Analysis
14.1.6. Key Developments
14.2. FAIR ISAAC CORPORATION
14.2.1. Key Facts
14.2.2. Business Description
14.2.3. Products and Services
14.2.4. Financial Overview
14.2.5. SWOT Analysis
14.2.6. Key Developments
14.3. SAS INSTITUTE INC
14.3.1. Key Facts
14.3.2. Business Description
14.3.3. Products and Services
14.3.4. Financial Overview
14.3.5. SWOT Analysis
14.3.6. Key Developments
14.4. SCIOINSPIRE, CORP
14.4.1. Key Facts
14.4.2. Business Description
14.4.3. Products and Services
14.4.4. Financial Overview
14.4.5. SWOT Analysis
14.4.6. Key Developments
14.5. WIPRO LIMITED
14.5.1. Key Facts
14.5.2. Business Description
14.5.3. Products and Services
14.5.4. Financial Overview
14.5.5. SWOT Analysis
14.5.6. Key Developments
14.6. IBM
14.6.1. Key Facts
14.6.2. Business Description
14.6.3. Products and Services
14.6.4. Financial Overview
14.6.5. SWOT Analysis
14.6.6. Key Developments
14.7. CONDUENT, INC
14.7.1. Key Facts
14.7.2. Business Description
14.7.3. Products and Services
14.7.4. Financial Overview
14.7.5. SWOT Analysis
14.7.6. Key Developments
14.8. HCL TECHNOLOGIES LIMITED
14.8.1. Key Facts
14.8.2. Business Description
14.8.3. Products and Services
14.8.4. Financial Overview
14.8.5. SWOT Analysis
14.8.6. Key Developments
14.9. CGI GROUP INC
14.9.1. Key Facts
14.9.2. Business Description
14.9.3. Products and Services
14.9.4. Financial Overview
14.9.5. SWOT Analysis
14.9.6. Key Developments
14.10. MCKESSON CORPORATION
14.10.1. Key Facts
14.10.2. Business Description
14.10.3. Products and Services
14.10.4. Financial Overview
14.10.5. SWOT Analysis
14.10.6. Key Developments
15. APPENDIX
15.1. ABOUT THE INSIGHT PARTNERS
15.2. GLOSSARY OF TERMS
The List of Companies
1. Verscend Technologies, Inc
2. Fair Isaac Corporation
3. SAS Institute Inc
4. SCIOInspire, Corp
5. Wipro Limited
6. IBM
7. Conduent, Inc
8. HCL Technologies Limited
9. CGI Group Inc
10. McKesson Corporation