According to research report “Healthcare Fraud Analytics Market by Solution Type (Descriptive, Predictive, Prescriptive), Application (Insurance Claim (Postpayment, Prepayment), Payment Integrity), Delivery (On-premise, Cloud), End User (Insurance, Government) – Global Forecast to 2025” published by MarketsandMarkets.
The healthcare fraud analytics market is projected to reach USD 4.6 billion by 2025 from USD 1.2 billion in 2020, at a CAGR of 29.8%.
Market growth can be attributed to the large number of fraudulent activities in healthcare; the increasing number of patients seeking health insurance; high returns on investment; and rising pharmacy claim-related frauds. However, the dearth of skilled personnel is likely to restrain the growth of this market.
The descriptive analytics segment dominated the healthcare fraud analytics market in 2019
The market is segmented based on solution type, delivery model, application, and end user. Based on the solution type, the descriptive analytics segment accounted for the largest share of the market in 2019. Descriptive analytics forms the base for the effective application of predictive or prescriptive analytics. Hence, these analytics use the basics of descriptive analytics and integrate them with additional sources of data in order to produce meaningful insights.
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By application, the insurance claims review segment accounted for the largest share of the market in 2019
On the basis of application, the market is segmented into insurance claims review, pharmacy billing misuse, payment integrity, and other applications. In 2019, the insurance claims review segment dominated the healthcare fraud analytics market. The increasing number of patients seeking health insurance, the rising number of fraudulent claims, and the growing adoption of the prepayment review model are expected to drive the growth of this segment in the coming years.
North America will dominate the healthcare fraud analytics market from 2020–2025
Geographically, the global market is segmented into North America, Europe, the Asia Pacific, Latin America, and the Middle East and Africa. North America accounted for the largest share of the market in 2019. The high share of the North American market is attributed to the large number of people having health insurance, growing healthcare fraud, favorable government anti-fraud initiatives, the pressure to reduce healthcare costs, technological advancements, and greater product and service availability in this region. Moreover, a majority of leading players in the healthcare fraud detection market have their headquarters in North America.
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Key Market players
The market is consolidated and competitive in nature. Major players in this market include IBM Corporation (US), Optum (US), SAS Institute (US), Change Healthcare (US), EXL Service Holdings (US), Cotiviti (US), Wipro Limited (India), Conduent (US), HCL (India), Canadian Global Information Technology Group (Canada), DXC Technology Company (US), Northrop Grumman Corporation (US), LexisNexis Group (US), and Pondera Solutions (US).
Key Questions Addressed in the Report
- Who are the top 10 players operating in the global healthcare fraud analytics market?
- What are the drivers, restraints, opportunities, and challenges in the market?
- What are the industry and technology trends in the market?
- What are the growth trends in the healthcare fraud analytics market at the segmental and overall market levels?
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