The Healthcare Fraud Analytics by The Business Research Company provides market overview across 60+ geographies in the seven regions – Asia-Pacific, Western Europe, Eastern Europe, North America, South America, the Middle East, and Africa, encompassing 27 major global industries. The report presents a comprehensive analysis over a ten-year historic period (2010-2021) and extends its insights into a ten-year forecast period (2023-2033).
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According to The Business Research Company’s Healthcare Fraud Analytics , The healthcare fraud analytics market size has grown exponentially in recent years. It will grow from $3 billion in 2023 to $3.8 billion in 2024 at a compound annual growth rate (CAGR) of 26.6%. The growth in the historic period can be attributed to rise in healthcare costs, complexity of healthcare systems, increasing volume of healthcare data, transition to electronic health records (ehrs), billing fraud challenges..
The healthcare fraud analytics market size is expected to see exponential growth in the next few years. It will grow to $9.66 billion in 2028 at a compound annual growth rate (CAGR) of 26.3%. The growth in the forecast period can be attributed to increasing sophistication of fraud schemes, integration of predictive analytics, regulatory evolution, global pandemic impact, enhanced patient identity verification.. Major trends in the forecast period include adoption of cloud-based analytics, user-friendly interfaces, automation in fraud investigations, real-time fraud detection, behavioral analytics..
A large number of fraudulent activities in the healthcare sector contribute to the growth of the healthcare fraud analytics market. Medical providers, patients, and third parties who intentionally deceive the healthcare system into acquiring unlawful benefits can commit fraud based on deception or misrepresentation. These fraud and abuse involve kickbacks, billing, billing for services not provided, medical testing, and other fraudulent activities. For instance, according to Blue Cross Blue Shield Association, a US-based federation, in 2021, The National Heath Care Anti-Fraud Association estimated that health care fraud costs the nation about $68 billion annually, about 3 percent of the nation’s $2.26 trillion in health care spending. Other estimates range as high as 10 percent of annual health care expenditure, or $230 billion. Thus, the increasing number of fraudulent activities in healthcare is contributing to the healthcare fraud market growth.
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The healthcare fraud analytics market covered in this report is segmented –
1) By Solution Type: Descriptive Analytics, Predictive Analytics, Prescriptive Analytics
2) By Delivery Model: On-Premise, On-Demand
3) By Application: Insurance Claims Review, Postpayment Review, Prepayment Review, Pharmacy Billing Misuse, Payment Integrity, Other Applications
4) By End User: Public & Government Agencies, Private Insurance Payers, Third-Party Service Providers
Major players in the healthcare fraud analytics market are focusing on investments to expand in the market. Rising investments in healthcare fraud analytics denote the increasing allocation of financial resources towards advanced analytical tools and technologies aimed at detecting and preventing fraudulent activities within the healthcare sector. For instance, in January 2021, Healthcare Fraud Shield, a US-based company that provides new and unique Fraud, Waste and Abuse (FWA) automated solutions to the healthcare industry, received a $50 million investment from Charlesbank Technology Opportunities Fund, a fund managed by Charlesbank Capital Partners, a New York-based middle market private investment firm. Through this investment, Healthcare Fraud Shield will be able to quickly create new features and implement the capabilities of its platform, such as the newly released AIShield product and the ground-breaking PreShield product, across insurance policies that cover millions of people.
The healthcare fraud analytics market report table of contents includes:
- Executive Summary
- Healthcare Fraud Analytics Market Characteristics
- Healthcare Fraud Analytics Market Trends And Strategies
- Healthcare Fraud Analytics Market – Macro Economic Scenario
- Global Healthcare Fraud Analytics Market Size and Growth
………..
- Global Healthcare Fraud Analytics Market Competitive Benchmarking
- Global Healthcare Fraud Analytics Market Competitive Dashboard
- Key Mergers And Acquisitions In The Healthcare Fraud Analytics Market
- Healthcare Fraud Analytics Market Future Outlook and Potential Analysis
- Appendix
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