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.
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Scope Of Healthcare Fraud Analytics Market
The Business Research Company’s reports encompass a wide range of information, including:
1. Market Size (Historic and Forecast): Analysis of the market’s historical performance and projections for future growth.
2. Drivers: Examination of the key factors propelling market growth.
3. Trends: Identification of emerging trends and patterns shaping the market landscape.
4. Key Segments: Breakdown of the market into its primary segments and their respective performance.
5. Focus Regions and Geographies: Insight into the most critical regions and geographical areas influencing the market.
6. Macro Economic Factors: Assessment of broader economic elements impacting the market.
Market Drivers –
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.
Market Trends –
Product innovations have emerged as the key trend gaining popularity in the 5G chipset market. The major players in the market are developing innovative products for market growth. For instance, in June 2021, Samsung Electronics, a South Korea-based electronics company, developed 3GPP Rel.16 compliant chipsets, a range of next-generation 5G chipsets that deliver cutting-edge 5G technologies. The new chipsets consist of a second-generation 5G modem System-on-Chip (SoC), a third-generation mmWave Radio Frequency Integrated Circuit (RFIC) chip, and a Digital Front End (DFE)-RFIC integrated chip. These are designed to increase power efficiency, boost performance, and reduce the size of 5G solutions.
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
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Regional Insights –
North America was the largest region in the healthcare fraud analytics market in 2023. North America is expected to be the fastest-growing region in the forecast period. The regions covered in the healthcare fraud analytics market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East, Africa
Key Companies –
Major companies operating in the healthcare fraud analytics market report are International Business Machines Corporation, Optum Inc., Statistical Analysis Software Institute Inc., Change Healthcare, EXL Service Holdings Inc., Cotiviti Inc., DXC Technology Company, Wipro Limited, Conduent Incorporated, Consultants to Government and Industry Inc., HCL Technologies Limited, Qlarant Inc., Northrop Grumman Corporation, LEXIS-NEXIS Group, Healthcare Fraud Shield, Sharecare Inc., FraudLens Inc., HMS Holding Corp., Codoxo, H20. ai, Pondera Solutions Inc., Friss International B. V., MultiPlan Inc., FraudScope, Osp Labs Private Limited, Fair Isaac Corporation, Mckesson Corp, Relx Group PLC, FraudHunt, FraudGuardian
Table of Contents
1. Executive Summary
2. Healthcare Fraud Analytics Market Report Structure
3. Healthcare Fraud Analytics Market Trends And Strategies
4. Healthcare Fraud Analytics Market – Macro Economic Scenario
5. Healthcare Fraud Analytics Market Size And Growth
…..
27. Healthcare Fraud Analytics Market Competitor Landscape And Company Profiles
28. Key Mergers And Acquisitions
29. Future Outlook and Potential Analysis
30. Appendix
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