Market Insights:
Market Research Future (MRFR) has revealed in its latest report that the global healthcare fraud detection market is set to thrive saliently at 30% CAGR during the forecast period 2017 to 2023. The increasing count of cases related to medical scams, false insurance claims, exploitation of medical funds, etc. has necessitated the adoption of healthcare fraud detection technology, and the trend is anticipated to continue across the review period.
With the developments in the healthcare sector, the number of frauds has been on the rise, which includes drug frauds, medical insurance frauds, and medicine frauds. The growth of healthcare fraud detection market is expected to accelerate considering the increasing number of scams.
The embracement of fraud analytics ensures optimum utilization of medical funds by minimizing embezzlement of funds and subsidies. Thus, the healthcare fraud detection market is likely to proliferate rapidly over the next couple of years.
Some of the factors responsible for holding the market growth through the review period are lack of skilled personnel, reluctance in the adoption of the technology, etc.
Competitive Dashboard:
Some of the key players profiled by MRFR in its report are SAS, Conduent, Optum, Pondera, IBM, and Wipro among others. The strategies devised by the players for garnering share and control over the market include acquisitions & developments, strategic alliances, technological developments, product portfolio expansion, innovation, etc.
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Market Segmentation:
By components, the healthcare fraud detection market is segmented into software and services. Among these, the services segment is likely to register a relatively higher CAGR during the projection period.
By kinds, the global healthcare fraud detection market has been segmented into predictive analytics, descriptive analytics, and prescriptive analytics. The prescriptive analytics segment is expected to show the steepest rise in the growth while descriptive analytics segment is estimated to be the primary revenue generator in the market.
By delivery models, the healthcare fraud detection market is segmented into on-demand, and on-premise. Among these, the on-demand segment is expected to demonstrate a relatively higher growth rate.
By end-users, the global healthcare fraud detection market has been segmented into employers, regulatory/public agencies, private insurance payers, third-party services, payment integrity, insurance claim reviews, and identity & case management.
Regional Analysis:
By region, the global healthcare fraud detection market has been segmented into Americas, Asia Pacific, Europe, and the Middle East & Africa. Americas currently accounts for the largest share of the global market and is expected to retain its dominance over the forecast period. Europe is likely to hold the second spot in the global healthcare fraud detection market. The growth of the market is attributable to technological developments, accessibility to products & services, etc. Asia Pacific is expected to remain a highly lucrative market throughout the assessment period.
Industry News:
In July 2018, Zelis Healthcare, a market-leading healthcare technology company, announced the launch of fully-integrated Zelis Intelligent Claims Routing Platform that leverages Microsoft Azure Artificial Intelligence. Zelis will help in minimizing the complexity that occurs due to errors, waste, fraud, and abuse.
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The global Healthcare Fraud Detection Market is expected to reach USD 2,242.7 Million by 2022 from USD 631.0 Million in 2017, at a CAGR of 28.9%.
The Research report provides a detailed overview of the major drivers, restraints, challenges, opportunities, current market trends, and strategies impacting the Healthcare Fraud Detection Market, along with revenue estimates & forecasts and market share analysis.The growth of the market is attributed to a large number of fraudulent activities in healthcare; increasing number of patients seeking health insurance; the prepayment review model; growing pressure of fraud, waste, and abuse on healthcare spending; and high returns on investment.Download PDF Brochure: https://www.marketsandmarkets.com/pdfdownloadNew.asp?id=221837663 Healthcare Fraud Detection Market segmentation: Based on Type Based on Component Based on Delivery Model Based on Application Based on End Users Based on RegionsThe Major Players Opearting in the Healthcare Fraud Detection Market:Key players in the Healthcare Fraud Detection Market include IBM (US), Optum (US), SAS (US), McKesson (US), SCIO (US), Verscend (US), Wipro (India), Conduent (US), HCL (India), CGI (Canada), DXC (US), Northrop Grumman (US), LexisNexis (US), and Pondera (US).IBM was the leading player in the global Healthcare Fraud Detection Market.
The company has a strong presence in North America, Europe, Asia, and Latin America.The company has a strong presence in the commercial and government healthcare payer markets.
Moreover, it has a strong sales and distribution network in more than 175 countries.
IBM invests heavily in research activities to continuously improve its product portfolio.The company focuses on inorganic strategies like acquisitions and partnerships.
For instance, in April 2016, IBM acquired Truven (US), a provider of cloud-based healthcare data, analytics, and insights.
Global Healthcare Fraud Detection Market: Information by Type (Descriptive Analytics, Predictive Analytics and Prescriptive Analytics), by Component (Services and Software), by Delivery Model (On-Premise and Cloud-Based), by Application (Insurance Claims Review and Payment Integrity), by End User (Private Insurance Payers, Public/Government Agencies and Third Party Service Providers) and by Region (North America, Europe, Asia-Pacific and the Middle East & Africa) - Forecast till 2024Healthcare Fraud Detection Market OverviewMarket Research Future (MRFR) has launched a new report on the Global Healthcare Fraud Detection Market is expected to register a CAGR of 28.83% to reach USD 3,787.68 Million by 2024.The problem of fraudulent claims is intensifying in the healthcare sector and is a burden to society.
Healthcare fraud detection generally involves account auditing and detective investigation for fraudulent activities.
Such fraudulent activities are detected by using statistical, analytical, deep learning, and predictive modeling methods.
The healthcare sector is witnessing more payment breaches than ever before due to which the adoption of healthcare fraud detection solutions has gained enormous importance.
Misinterpretation, as well as intentional deceit in facts related to payments, have given rise to the need for robust fraud detection systems.
As greater number of patients are seeking healthcare insurance, the chance of healthcare fraudulent activities are also increasing manifold.On the other hand, despite various benefits aligned with fraud detection solutions, their implementation is restricted by time-consuming deployment process and the need for frequent software upgrades.Healthcare Fraud Detection Market SegmentationThe healthcare fraud detection market has been segmented based on component, delivery model, type, application, end-user.By component, the healthcare fraud detection market has been segmented into services and software.By delivery model, the healthcare fraud detection market has been segmented into on-premise delivery models and on-demand delivery models.By type, the healthcare fraud detection market has been segmented into descriptive analytics, predictive analytics, and prescriptive analytics.
Fraud Detection solutions vary from vendor to vendor.
Some vendors offer rule-based models while others offer AI-based technologies, but broadly, these solutions are classified based on the type of analytics used—descriptive analytics, predictive analytics, and prescriptive analytics.
The prescriptive analytics segment registered the highest growth in the healthcare fraud analytics market during the forecast period.
The high adoption of this technology is attributed to its advantages, such as rapid detection and investigation of suspects, claimants, and claim-level behavior from unstructured and/or semi-structured data.In 2019, public & government agencies accounted for the largest share of the healthcare fraud analytics market, by end-user.Based on end-user, the healthcare fraud detection market is segmented into public & government agencies, private insurance payers, employers, and third-party service providers.
Descriptive analytics forms the base for the effective application of predictive or prescriptive analytics.
Hence, these analytics use the basics of descriptive analytics and integrate them with additional sources of data in order to produce meaningful insights.By application, the insurance claims review segment accounted for the largest share of the market in 2019On the basis of application, the market is segmented into insurance claims review, pharmacy billing misuse, payment integrity, and other applications.
