Healthcare Fraud Detection Market – Size & Trends

The Healthcare Fraud Detection Global Market Report 2024 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 Detection Global Market Report 2024, 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..

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.

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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

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 report table of contents includes:

 

1. Executive Summary
2. Healthcare Fraud Detection Market Characteristics
3. Healthcare Fraud Detection Market Trends And Strategies
4. Healthcare Fraud Detection Market – Macro Economic Scenario
5. Global Healthcare Fraud Detection Market Size and Growth

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31. Global Healthcare Fraud Detection Market Competitive Benchmarking
32. Global Healthcare Fraud Detection Market Competitive Dashboard
33. Key Mergers And Acquisitions In The Healthcare Fraud Detection Market
34. Healthcare Fraud Detection Market Future Outlook and Potential Analysis
35. Appendix

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