The
global Healthcare
Fraud Analytics Market size is expected to reach USD 11.2 billion by 2030,
according to a new report by Grand View Research, Inc. The market is projected
to advance at a CAGR of 24.3% from 2022 to 2030. The rising incidence of
fraudulent activities in the healthcare sector, increasing number of patients
seeking health insurance, high returns on investment, and the increasing number
of pharmacy claims-related frauds are the major drivers propelling the market
growth.
The
COVID-19 pandemic has drastically affected the healthcare industry. The
healthcare industry has observed various fraud cases on the part of doctors,
patients, physicians, and other healthcare specialists. It is observed that
many medical specialists and healthcare providers are engaged in fraudulent
activities for profit gains. Many instances prove the increasing number of
fraud cases during the COVID-19 pandemic.
The
adoption of software used for fraud detection by insurance companies is
increasing due to the rising availability of the same in developed regions. For
instance, in February 2022, The Canadian Life and Health Insurance Association
(CLHIA) launched an industry initiative to pool claims data and use advanced
artificial intelligence tools which enhance the investigation and detection of
benefits fraud.
Moreover,
in June 2021, Artivatic launched the Alfred- AI Health Claims platform. This
platform automates end-to-end health claims, and the abuse & fraud
detection capacity is almost 30% or more. Moreover, it enables users to
self-learn and develop a system for decision-making, risk assessment, and fraud
detection. This growth in the availability of the software is because of
increasing healthcare expenditure, which triggers the companies to come up with
a product or service to meet the market demand.
The
rising incidence of fraudulent activities in the healthcare sector drives the
market globally. For example, according to data published by the National
Library of Medicine, the fraudulent activities count raised from 30 in 2019 to
52 in the year 2021. The market is highly competitive and consists of several
major players. With the rising adoption of healthcare IT solutions
and the increasing number of fraud cases, smaller or private players are
anticipated to enter the market in the coming years.
Initiatives
like collaborations or partnerships with local players, acquisitions, or new
product launches by market players contribute to the market growth. For
example, in April 2019, HCL Technologies Limited launched the CyberSecurity
Fusion Center in Texas, U.S., and expanded its U.S. operations with the
CyberSecurity Center.
Related Press
Release@ Healthcare
Fraud Analytics Market Report
List of Key Players in the Healthcare Fraud
Analytics Market
- IBM
- Optum, Inc.
- Cotiviti, Inc
- DXC Technology
- SAS Institute, Inc.
- EXL Service Holdings, Inc
- Wipro Limited
- Conduent, Inc
- HCL Technologies Limited
- OSP Labs
Healthcare Fraud Analytics Market Report Highlights
- In terms of
revenue, the descriptive analytics segment dominated the solution type
segment with a share of around 40.5% in 2021, owing to its high
penetration
- Based on the
delivery model, the on-premise segment is expected to show lucrative
growth during the forecast period, owing to its higher deployment as
compared to the cloud-based delivery model
- Insurance
claims review dominated the application segment with a share of around 35%
as of 2021. The growth can be attributed to the rising adoption of health
insurance
- The
employers' segment is expected to show the fastest growth during the
forecast period, owing to the increasing demand for healthcare fraud
analytics software by employers for better cost management
- The North
American region accounted for the largest market share of around 38% in
2021, owing to the presence of major market players in the region
Healthcare Fraud Analytics Market Report
Scope
|
Report Attribute |
Details |
|
The market size value in 2022 |
USD 1.97 billion |
|
The revenue forecast in 2030 |
USD 11.23 billion |
|
Growth Rate |
CAGR of 24.3% from 2022 to 2030 |
|
Base year for estimation |
2021 |
|
Actual estimates/Historical data |
2017 - 2020 |
|
Forecast period |
2022 - 2030 |
Related Reports@
Healthcare Data Annotation Tools Market
Healthcare Information System Market
Healthcare Fraud Analytics Market Segmentation
Grand
View Research has segmented the global healthcare fraud analytics market based
on solution type, application, delivery model, end-user, and region:
Solution Type Outlook (Revenue, USD Million, 2017 - 2030)
- Descriptive
Analytics
- Predictive
Analytics
- Prescriptive
Analytics
Delivery Model Outlook (Revenue, USD Million, 2017 -
2030)
- On-premise
- Cloud-based
Application Type Outlook (Revenue, USD Million, 2017 -
2030)
- Insurance
Claim Review
- Postpayment
Review
- Prepayment
Review
- Pharmacy
Billing Issue
- Payment
Integrity
- Others
End-User Outlook (Revenue, USD Million, 2017 - 2030)
- Public &
Government Agencies
- Private
Insurance Payers
- Third-party
Service Providers
- Employers
Regional Outlook (Revenue, USD Million, 2017 - 2030)
- North
America
- U.S.
- Canada
- Europe
- U.K.
- Germany
- France
- Italy
- Spain
- Asia Pacific
- Japan
- China
- India
- Australia
- South Korea
- Latin
America
- Brazil
- Mexico
- Argentina
- Middle East
& Africa
- South
Africa
- Saudi
Arabia
- UAE
About Us:
Grand
View Research, Inc. is a U.S. based market research and consulting company,
registered in the State of California and headquartered in San Francisco. The
company provides syndicated research reports, customized research reports, and
consulting services. To help clients make informed business decisions, the
company offers market intelligence studies ensuring relevant and fact-based
research across a range of industries including technology, chemicals,
materials, healthcare and energy.
Contact:
Sherry James
Corporate Sales Specialist, USA
Grand View Research, Inc
Phone: 1-415- 349-0058
Toll Free: 1-888- 202-9519
Email: sales@grandviewresearch.com
For More Information: https://www.grandviewresearch.com
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