Global Healthcare Fraud Analytics Market Share to Grow to USD 4,500 Million By 2026, North America accounted for the maximum revenue share during forecast year: Facts & Factors

Facts & Factors
·8 min read

According to the [180+ Pages Report] research report, the global Healthcare Fraud Analytics Market was estimated at USD 900 Million in 2019 and is expected to reach USD 4500 Million by 2026, at 28% CAGR through 2027. Top market players include HCL, Northrop Grumman Corporation, Wipro Limited, EXL Service Holdings, IBM Corporation, SAS Institute, Pondera Solutions, LexisNexis Group and others.

New York, NY, Nov. 26, 2020 (GLOBE NEWSWIRE) -- Facts and Factors have published a new research report titled “Healthcare Fraud Analytics Market By Solution Type (Predictive Analytics, Descriptive Analytics, and Prescriptive Analytics), By Delivery Model (On-Demand and On-Premises), By Application (Payment Integrity, Insurance Claims Review, Pharmacy Billing Misuse, and Identity & Case Management), By End User (Third-Party Service Providers, Public & Government Agencies, Employers, and Private Insurance Payers), And By Region: Global Industry Outlook, Market Size, Business Intelligence, Consumer Preferences, Statistical Surveys, Comprehensive Analysis, Historical Developments, Current Trends, and Forecasts, 2020–2026”.

According to the research study, the global Healthcare Fraud Analytics Market was estimated at USD 900 Million in 2019 and is expected to reach USD 4500 Million by 2026. The global Healthcare Fraud Analytics Market is expected to grow at a compound annual growth rate (CAGR) of 28% from 2020 to 2027.

Global Healthcare Fraud Analytics Market is growing due to the rise in demand in the healthcare sector for reliable fraud detection is anticipated to drive the growth of the market during the forecast period.

Fraudulent activities have been increasing in the healthcare sector along with the rise in technology. Patients have been seeking health insurance for years and the number is increasing. Healthcare fraud analysts train the model to engage and recognize monitoring behaviors as claims come in. In short, this is a method used to analyze data to identify the relationships among providers, people, and claims.

Browse through 34 Tables & 84 Figures spread over 190+ Pages and in-depth TOC on “Global Healthcare Fraud Analytics Market Size & Share 2020: Industry Trends and Applications, Analysis Report Forecast to 2027”.

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Sectors such as Public & Government Agencies, Private Insurance Payers, Third-party Service Providers, and Employers are the end-users of healthcare fraud analytics. Many of the fraudulent claims have been caught in the last few decades. For instance, according to data published by Perspectives in Health Information Management organization, HCFAC collected over $11.2 billion in fraudulent claims during the time period from 1997 to 2007. Besides this, HCFAC collected $1.8 billion in fraudulent claims in 2007 alone. In June 2018, Wipro merged with Opera Solutions; LLC.. The partnership launched an end-to-end solution for addressing the issue of abuse and fraud in healthcare insurance claims in the United States.

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The increasing count of people opting for healthcare insurance has been expanding the target market growth. In addition, mounting pressure on healthcare services providers associated with the fraud & abuse incidences is expected to propel the target market growth over the forecast period. However, the lack of skilled personnel is anticipated to restrain the target market growth of the forecast period. Also, the incorporation of artificial intelligence in fraud analysis on the cloud-based platform is likely to create growth opportunities for the target market key players over the forecast period.

Top Market Players

The top industrial players operating in the global market are HCL, Northrop Grumman Corporation, Wipro Limited, EXL Service Holdings, IBM Corporation, SAS Institute, Pondera Solutions, LexisNexis Group, Conduent, Canadian Global Information Technology Group, Cotiviti, Optum, Change Healthcare, and DXC Technology Company, and others.

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The “descriptive analytics” category under the solution type segment accounted for a major share in the global market

In 2019, the descriptive analytics segment led the global healthcare fraud analytics market by holding a maximum revenue share. Even the applications of the other two categories under the solution type segment: prescriptive and predictive analytics are based on descriptive analytics.

The category “insurance claims review”, under the application segment, dominated the global market in 2019

In 2019, the insurance claims review under the application segment held the largest share of the global healthcare fraud analytics market. With the continuous rise in the adoption of healthcare insurance services & the prepayment review model worldwide, the fraudulent claim incidences are growing at a substantial rate, thereby likely to propel the insurance claims review segment during the forecast period.

Based on By Solution Type, the target market is bifurcated into Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics. Among these, the descriptive analytics category is expected to lead the global healthcare fraud analytics market by holding a maximum revenue share owing to the surging demand for it in the healthcare industry. On the basis of the Delivery Model, the target market is segmented as On-Premises and On-Demand. Among these, the On-Demand category is anticipated to be the leading one. On the basis of Application, the target market is segmented as Insurance Claims Review, Payment Integrity, Identity & Case Management, and Pharmacy Billing Misuse. Among these, the Insurance Claims Reviews category is anticipated to lead the Applications segment. Based on End User, the worldwide Healthcare Fraud Analytics Market is bifurcated as Employers, Public & Government Agencies, Third-Party Service Providers, and Private Insurance Payers. Among these, Public & Government Agencies is anticipated to hold the lead as most of the government agencies are adopting healthcare fraud analytics.

Browse the full “Healthcare Fraud Analytics Market By Solution Type (Predictive Analytics, Descriptive Analytics, and Prescriptive Analytics), By Delivery Model (On-Demand and On-Premises), By Application (Payment Integrity, Insurance Claims Review, Pharmacy Billing Misuse, and Identity & Case Management), By End User (Third-Party Service Providers, Public & Government Agencies, Employers, and Private Insurance Payers), And By Region: Global Industry Outlook, Market Size, Business Intelligence, Consumer Preferences, Statistical Surveys, Comprehensive Analysis, Historical Developments, Current Trends, and Forecasts, 2020–2026" report at https://www.fnfresearch.com/sample/global-healthcare-fraud-analytics-market-by-solution-type-789

In terms of region, the global healthcare fraud analytics market is classified as North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. Among these regions, North America is expected to lead the target market owing to the rise in the adoption of health insurance terms and plans by the population in the region. In addition, mounting incidences of healthcare fraud and technological advancements in the region has been growing the target market in the region as well.

North America to attain the leading position in the global healthcare fraud analytics industry during the study timeframe
In 2019, North America accounted for the maximum revenue share generated by the global healthcare fraud analytics market. The supremacy of the North American healthcare fraud analytics market is attributed to the wide adoption of health insurance plans by people in the region, rising incidences of healthcare fraud, favorable anti-fraud regulations & initiatives introduced by the government, and technological advancements.

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This report segments the global healthcare fraud analytics market as follows:

Global Healthcare Fraud Analytics Market: Solution Type Segmentation Analysis

  • Predictive Analytics

  • Descriptive Analytics

  • Prescriptive Analytics

Global Healthcare Fraud Analytics Market: Delivery Model Segmentation Analysis

  • On-demand

  • On-premises

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