Healthcare

Healthcare Fraud Detection Market Growth, Trends, Industry Forecast Report 2033

The healthcare fraud detection global market report 2024 from The Business Research Company provides comprehensive market statistics, including global market size, regional shares, competitor market share, detailed segments, trends, and opportunities. This report offers an in-depth analysis of current and future industry scenarios, delivering a complete perspective for thriving in the industrial automation software market.

Healthcare Fraud Detection Market, 2024 report by The Business Research Company offers comprehensive insights into the current state of the market and highlights future growth opportunities.

Market Size –

The healthcare fraud detection market size has grown exponentially in recent years. It will grow from $2.78 billion in 2023 to $3.6 billion in 2024 at a compound annual growth rate (CAGR) of 29.3%. The growth in the historic period can be attributed to increased cyberthreats, patient identity verification, market competition, fraudulent claim identification, increased awareness and training.

The healthcare fraud detection market size is expected to see exponential growth in the next few years. It will grow to $10.35 billion in 2028 at a compound annual growth rate (CAGR) of 30.2%. The growth in the forecast period can be attributed to regulatory changes, increasing digitalization, sophistication of fraud schemes, focus on insurance fraud, data security enhancement. Major trends in the forecast period include advanced technology integration, real-time monitoring, behavioral analytics, blockchain for security, patient identity verification.

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Scope Of Healthcare Fraud Detection Market

The Business Research Company’s reports encompass a wide range of information, including:

Market Size (Historic and Forecast): Analysis of the market’s historical performance and projections for future growth.
Drivers: Examination of the key factors propelling market growth.
Trends: Identification of emerging trends and patterns shaping the market landscape.
Key Segments: Breakdown of the market into its primary segments and their respective performance.
Focus Regions and Geographies: Insight into the most critical regions and geographical areas influencing the market.
Macro Economic Factors: Assessment of broader economic elements impacting the market.

Healthcare Fraud Detection Market Overview

Market Drivers –

The rise in fraudulent events in the healthcare industry is expected to propel the healthcare fraud detection market going forward. Fraudulent events in healthcare refer to the deliberate misrepresentation of patient data and insurance information in order to obtain an unfair or illegal gain or to deprive a user of a legal right. For instance, in 2021, the Department of Justice (DOJ) opened 831 new criminal health care fraud investigations. Moreover, in 2021, DOJ opned 805 new civil health care fraud investigations. According to data published by the United States Sentencing Commission, a US-based agency that articulates sentencing guidelines, in August 2022, 336 health care fraud offenders were identified in fiscal year 2021, making up 8.0% of total theft, property damage, and fraud charges. Therefore, the rise in fraudulent events in the healthcare industry is expected to drive the growth of the healthcare fraud detection market.

Market Trends –

Adoption of advanced analytics tools is a key trend gaining popularity in the healthcare fraud detection market. Major players are concentrating their efforts on creating innovative technologies to sustain their position in the healthcare fraud detection market. For instance, in January 2022, Premier, Inc., a US-based healthcare technology company, launched “”””INSights”””” based on PINC AITM technology. Insights is a vendor-neutral analytics platform that has access to the risk-adjusted, standardised, and cleaned healthcare data from PINC AITM. Insights is designed for healthcare providers to lower the workload associated with data preparation and analytics development for quick gains in clinical, quality, and financial outcomes.

The healthcare fraud detection market covered in this report is segmented –

1) By Type: Descriptive Analytics, Predictive Analytics, Prescriptive Analytics

2) By Model: On-premise Delivery, On-demand Delivery

3) By Component: Services, Software

4) By Application: Insurance Claims Review, Payment Integrity

5) By End User: Healthcare Payers, Government Agencies, Other end-users

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Regional Insights –

North America was the largest region in the healthcare fraud detection market in 2023. The regions covered in the healthcare fraud detection 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 detection market report are International Business Machines Corporation, Cotiviti Inc., Fair Isaac Corporation, SAS Institute Inc., CGI Inc., DXC Technology Company, RELX Group plc, EXL Service Holdings Inc., HCL Technologies Limited, UnitedHealth Group Incorporated, Conduent Incorporated, Change Healthcare LLC, OSP Labs LLC, Codoxo Inc., Wipro Limited, Qlarant Inc., Northrop Grumman Corporation, LexisNexis Risk Solutions Group, Healthcare Fraud Shield LLC, Sharecare Inc., FraudLens Inc., HMS Holdings Corp., H2O.ai Inc., Pondera Solutions Inc., FRISS B.V., MultiPlan Corporation, FraudScope Inc., McKesson Corporation, FraudGuard LLC, FraudCracker LLC

Table of Contents

Executive Summary
Healthcare Fraud Detection Market Characteristics
Healthcare Fraud Detection Market Trends And Strategies
Healthcare Fraud Detection Market – Macro Economic Scenario
Global Healthcare Fraud Detection Market Size and Growth

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Key Mergers And Acquisitions In The Healthcare Fraud Detection Market
Healthcare Fraud Detection Market Future Outlook and Potential Analysis
Appendix

List Of Tables:

Table 1: Global Historic Market Growth, 2018-2023, $ Billion

Table 2: Global Forecast Market Growth, 2023-2028F, 2033F, $ Billion

Table 3: Global Healthcare Fraud Detection Market, Segmentation By Type, Historic and Forecast, 2018-2023, 2023-2028F, 2033F, $ Billion

Table 4: Global Healthcare Fraud Detection Market, Segmentation By Model, Historic and Forecast, 2018-2023, 2023-2028F, 2033F, $ Billion

Table 5: Global Healthcare Fraud Detection Market, Segmentation By Component, Historic and Forecast, 2018-2023, 2023-2028F, 2033F, $ Billion

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Table 76: International Business Machines Corporation Financial Performance

Table 77: Cotiviti Inc. Financial Performance

Table 78: Fair Isaac Corporation Financial Performance

Table 79: SAS Institute Inc. Financial Performance

Table 80: CGI Inc. Financial Performance

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