Healthcare Fraud Analytics Market Size, Share, Growth Analysis, Forecast Report 2032

The global Healthcare Fraud Analytics Market Size was worth around USD 2.51 Billion in 2023 and is predicted to grow to around USD 18.73 Billion 2032 with a compound annual growth rate (CAGR) of roughly 25% between 2024 and 2032.

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The report covers in-depth analysis of the strategies adopted by major competitors in the global Healthcare Fraud Analytics market. To understand the competitive landscape in the global Healthcare Fraud Analytics market, an analysis of Porter’s Five Forces model is also included. The research study comprises market attractiveness analysis, wherein all the segments are benchmarked on the basis of their market size and growth rate.

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The research study provides a decisive view on the global Healthcare Fraud Analytics market based on Solution Type, Delivery Model, Component, Application, End-User, and Region. All the segments of the market have been analyzed based on the past, present, and future trends. The market is estimated from 2024 to 2032.

Healthcare Fraud Analytics Market Growth

Healthcare Fraud Analytics market growth is primarily attributed to the increasing number of fraudulent activities in the healthcare sector and the mounting number of patients opting for health insurance. On the other hand, the increasing reimbursement policies and surging pharmacy claim-related frauds are expected to augment the market growth during the forecast period. Descriptive analytics role in forming the base for the effective application of predictive or prescriptive analytics will supplement the expansion of the global Healthcare Fraud Analytics market. In addition to this, the growing acceptance of the prepayment review model will supplement the growth of this category in the upcoming years.

Additionally, the supportive government anti-fraud initiatives are majorly helping in the easy acceptance of healthcare fraud analytics across various regions. The pressure to lower healthcare costs, technological innovations, and the increasing availability of product and service across the globe is expected to augment the market growth. Moreover, the rising presence of headquarters of many of the leading players in the Healthcare Fraud Analytics market in various regions will further aid in the market growth. However, the lack of skilled personnel is likely to hamper the growth of Healthcare Fraud Analytics market.

Healthcare Fraud Analytics Market Report Scope

Healthcare Fraud Analytics Market Segmentation Analysis

On the basis of solution type, the global Healthcare Fraud Analytics market is divided into Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics.

Based on delivery model, the market is segregated into On-premise and On-Demand.

By component, the market for healthcare fraud analytics is segmented into Services and Software.

In terms of application, the Healthcare Fraud Analytics market is categorized into Insurance Claims Review, Pharmacy Billing Misuse, Payment Integrity, and Others.

Based on end-user, the market is classified into Private Insurance Payers, Public & Government Agencies, Third-Party Service Providers, and Employers.

Regional Analysis

The regional segmentation comprises the past, present, and estimated demand for the Middle East & Africa, North America, Asia Pacific, Latin America, and Europe. The regional segment is further split into the U.S., Canada, Mexico, UK, France, Germany, China, Japan, India, South Korea, Brazil, and Argentina among others.

Some of the key players of the global Healthcare Fraud Analytics market include

• Optum
• EXL Service Holdings
• SAS Institute
• IBM Corporation
• DXC Technology Company
• Change Healthcare
• Cotiviti
• Conduent
• HCL
• Wipro Limited
• LexisNexis Group
• Canadian Global Information Technology Group
• Northrop Grumman Corporation
• Pondera Solutions.

The report on the global Healthcare Fraud Analytics market is segmented into:

By Solution Type Segments

• Descriptive Analytics
• Predictive Analytics
• Prescriptive Analytics

By Delivery Model Segments

• On-Premise
• On-Demand

By Application Segments

• Insurance Claims Review
  • Post payment Review
  • Prepayment Review
• Pharmacy Billing Misuse
• Payment Integrity
• Others

By End-User Segments

• Public & Government Agencies
• Private Insurance Payers
• Third-party Service Providers
• Employers

By Regional Segments

• North America
  • The U.S.
  • Canada
• Europe
  • France
  • The UK
  • Spain
  • Germany
  • Italy
  • Rest of Europe
• Asia Pacific
  • China
  • Japan
  • India
  • South Korea
  • Southeast Asia
  • Rest of Asia Pacific
• Latin America
  • Brazil
  • Mexico
  • Rest of Latin America
• Middle East & Africa
  • GCC
  • South Africa
  • Rest of Middle East & Africa