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PUBLISHER: IMARC | PRODUCT CODE: 1308170
PUBLISHER: IMARC | PRODUCT CODE: 1308170
Healthcare Fraud Detection Market: Global Industry Trends, Share, Size, Growth, Opportunity and Forecast 2023-2028
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Market Overview:
The global healthcare fraud detection market size reached US$ 2.0 Billion in 2022. Looking forward, IMARC Group expects the market to reach US$ 7.9 Billion by 2028, exhibiting a growth rate (CAGR) of 23.5% during 2023-2028.
Healthcare fraud detection aids in detecting and preventing healthcare fraud, waste, and abuse at every stage of the claim process and reducing inappropriate payments. It connects existing payment integrity solutions and consolidates data from internal and external sources, such as claims systems, watch lists, third parties, and unstructured texts for efficient data management. It relies on various advanced analytic and artificial learning (AI) techniques, including modern statistical, machine learning (ML), deep learning, and text analytics algorithms. Apart from this, it uses a flexible process to assist operational, clinical, and investigative evaluations and store all relevant case information.
Healthcare Fraud Detection Market Trends:
Due to an increase in the number of patients seeking health insurance, there is a rise in the demand for healthcare fraud detection solutions. This, along with the growing prepayment review model in the healthcare industry, represents one of the key factors driving the market. Moreover, the increasing number of pharmacy claims-related frauds across the globe is propelling the growth of the market. In addition, there is a rise in the demand for solutions that have biometric sensors to identify frauds. This, coupled with the growing adoption of healthcare fraud analytics, especially in developing countries, is positively influencing the market. Besides this, the increasing integration of artificial intelligence (AI) in healthcare fraud detection is offering lucrative growth opportunities to industry investors. Apart from this, governments of several countries are undertaking initiatives to review healthcare insurance claims and save money of consumers and nations. In line with this, the burgeoning healthcare industry is bolstering the growth of the market. Other growth-inducing factors are the increasing returns on investment (ROI), rising use of social media, and funding for the implementation of several information and technology (IT) platforms.
Key Market Segmentation:
IMARC Group provides an analysis of the key trends in each sub-segment of the global healthcare fraud detection market report, along with forecasts at the global, regional and country level from 2023-2028. Our report has categorized the market based on component, type, delivery mode, application and end user.
Breakup by Component:
Software
Services
Breakup by Type:
Descriptive Analytics
Predictive Analytics
Prescriptive Analytics
Breakup by Delivery Mode:
On-premises
On-demand
Breakup by Application:
Insurance Claims Review
Payment Integrity
Breakup by End User:
Private Insurance Payers
Government Agencies
Others
Breakup by Region:
North America
United States
Canada
Asia-Pacific
China
Japan
India
South Korea
Australia
Indonesia
Others
Europe
Germany
France
United Kingdom
Italy
Spain
Russia
Others
Latin America
Brazil
Mexico
Others
Middle East and Africa
Competitive Landscape:
The competitive landscape of the industry has also been examined along with the profiles of the key players being CGI Inc., Conduent Inc., ExlService Holdings Inc., Fair Isaac Corporation, HCL Technologies Limited, International Business Machines Corporation, Northrop Grumman Corporation, RELX Group plc, SAS Institute Inc., UnitedHealth Group and Wipro Ltd.
Key Questions Answered in This Report:
- How has the global healthcare fraud detection market performed so far and how will it perform in the coming years?
- What has been the impact of COVID-19 on the global healthcare fraud detection market?
- What are the key regional markets?
- What is the breakup of the market based on the component?
- What is the breakup of the market based on the type?
- What is the breakup of the market based on the delivery mode?
- What is the breakup of the market based on the application?
- What is the breakup of the market based on the end user?
- What are the various stages in the value chain of the industry?
- What are the key driving factors and challenges in the industry?
- What is the structure of the global healthcare fraud detection market and who are the key players?
- What is the degree of competition in the industry?
Product Code: SR112023A5536
Table of Contents
1 Preface
2 Scope and Methodology
- 2.1 Objectives of the Study
- 2.2 Stakeholders
- 2.3 Data Sources
- 2.3.1 Primary Sources
- 2.3.2 Secondary Sources
- 2.4 Market Estimation
- 2.4.1 Bottom-Up Approach
- 2.4.2 Top-Down Approach
- 2.5 Forecasting Methodology
3 Executive Summary
4 Introduction
- 4.1 Overview
- 4.2 Key Industry Trends
5 Global Healthcare Fraud Detection Market
- 5.1 Market Overview
- 5.2 Market Performance
- 5.3 Impact of COVID-19
- 5.4 Market Forecast
6 Market Breakup by Component
- 6.1 Software
- 6.1.1 Market Trends
- 6.1.2 Market Forecast
- 6.2 Services
- 6.2.1 Market Trends
- 6.2.2 Market Forecast
7 Market Breakup by Type
- 7.1 Descriptive Analytics
- 7.1.1 Market Trends
- 7.1.2 Market Forecast
- 7.2 Predictive Analytics
- 7.2.1 Market Trends
- 7.2.2 Market Forecast
- 7.3 Prescriptive Analytics
- 7.3.1 Market Trends
- 7.3.2 Market Forecast
8 Market Breakup by Delivery Mode
- 8.1 On-premises
- 8.1.1 Market Trends
- 8.1.2 Market Forecast
- 8.2 On-demand
- 8.2.1 Market Trends
- 8.2.2 Market Forecast
9 Market Breakup by Application
- 9.1 Insurance Claims Review
- 9.1.1 Market Trends
- 9.1.2 Market Forecast
- 9.2 Payment Integrity
- 9.2.1 Market Trends
- 9.2.2 Market Forecast
10 Market Breakup by End User
- 10.1 Private Insurance Payers
- 10.1.1 Market Trends
- 10.1.2 Market Forecast
- 10.2 Government Agencies
- 10.2.1 Market Trends
- 10.2.2 Market Forecast
- 10.3 Others
- 10.3.1 Market Trends
- 10.3.2 Market Forecast
11 Market Breakup by Region
- 11.1 North America
- 11.1.1 United States
- 11.1.1.1 Market Trends
- 11.1.1.2 Market Forecast
- 11.1.2 Canada
- 11.1.2.1 Market Trends
- 11.1.2.2 Market Forecast
- 11.1.1 United States
- 11.2 Asia-Pacific
- 11.2.1 China
- 11.2.1.1 Market Trends
- 11.2.1.2 Market Forecast
- 11.2.2 Japan
- 11.2.2.1 Market Trends
- 11.2.2.2 Market Forecast
- 11.2.3 India
- 11.2.3.1 Market Trends
- 11.2.3.2 Market Forecast
- 11.2.4 South Korea
- 11.2.4.1 Market Trends
- 11.2.4.2 Market Forecast
- 11.2.5 Australia
- 11.2.5.1 Market Trends
- 11.2.5.2 Market Forecast
- 11.2.6 Indonesia
- 11.2.6.1 Market Trends
- 11.2.6.2 Market Forecast
- 11.2.7 Others
- 11.2.7.1 Market Trends
- 11.2.7.2 Market Forecast
- 11.2.1 China
- 11.3 Europe
- 11.3.1 Germany
- 11.3.1.1 Market Trends
- 11.3.1.2 Market Forecast
- 11.3.2 France
- 11.3.2.1 Market Trends
- 11.3.2.2 Market Forecast
- 11.3.3 United Kingdom
- 11.3.3.1 Market Trends
- 11.3.3.2 Market Forecast
- 11.3.4 Italy
- 11.3.4.1 Market Trends
- 11.3.4.2 Market Forecast
- 11.3.5 Spain
- 11.3.5.1 Market Trends
- 11.3.5.2 Market Forecast
- 11.3.6 Russia
- 11.3.6.1 Market Trends
- 11.3.6.2 Market Forecast
- 11.3.7 Others
- 11.3.7.1 Market Trends
- 11.3.7.2 Market Forecast
- 11.3.1 Germany
- 11.4 Latin America
- 11.4.1 Brazil
- 11.4.1.1 Market Trends
- 11.4.1.2 Market Forecast
- 11.4.2 Mexico
- 11.4.2.1 Market Trends
- 11.4.2.2 Market Forecast
- 11.4.3 Others
- 11.4.3.1 Market Trends
- 11.4.3.2 Market Forecast
- 11.4.1 Brazil
- 11.5 Middle East and Africa
- 11.5.1 Market Trends
- 11.5.2 Market Breakup by Country
- 11.5.3 Market Forecast
12 SWOT Analysis
- 12.1 Overview
- 12.2 Strengths
- 12.3 Weaknesses
- 12.4 Opportunities
- 12.5 Threats
13 Value Chain Analysis
14 Porters Five Forces Analysis
- 14.1 Overview
- 14.2 Bargaining Power of Buyers
- 14.3 Bargaining Power of Suppliers
- 14.4 Degree of Competition
- 14.5 Threat of New Entrants
- 14.6 Threat of Substitutes
15 Price Analysis
16 Competitive Landscape
- 16.1 Market Structure
- 16.2 Key Players
- 16.3 Profiles of Key Players
- 16.3.1 CGI Inc.
- 16.3.1.1 Company Overview
- 16.3.1.2 Product Portfolio
- 16.3.1.3 Financials
- 16.3.1.4 SWOT Analysis
- 16.3.2 Conduent Inc.
- 16.3.2.1 Company Overview
- 16.3.2.2 Product Portfolio
- 16.3.2.3 Financials
- 16.3.2.4 SWOT Analysis
- 16.3.3 ExlService Holdings Inc.
- 16.3.3.1 Company Overview
- 16.3.3.2 Product Portfolio
- 16.3.3.3 Financials
- 16.3.4 Fair Isaac Corporation
- 16.3.4.1 Company Overview
- 16.3.4.2 Product Portfolio
- 16.3.4.3 Financials
- 16.3.4.4 SWOT Analysis
- 16.3.5 HCL Technologies Limited
- 16.3.5.1 Company Overview
- 16.3.5.2 Product Portfolio
- 16.3.5.3 Financials
- 16.3.5.4 SWOT Analysis
- 16.3.6 International Business Machines Corporation
- 16.3.6.1 Company Overview
- 16.3.6.2 Product Portfolio
- 16.3.6.3 Financials
- 16.3.7 Northrop Grumman Corporation
- 16.3.7.1 Company Overview
- 16.3.7.2 Product Portfolio
- 16.3.7.3 Financials
- 16.3.7.4 SWOT Analysis
- 16.3.8 RELX Group plc
- 16.3.8.1 Company Overview
- 16.3.8.2 Product Portfolio
- 16.3.8.3 Financials
- 16.3.8.4 SWOT Analysis
- 16.3.9 SAS Institute Inc.
- 16.3.9.1 Company Overview
- 16.3.9.2 Product Portfolio
- 16.3.9.3 SWOT Analysis
- 16.3.10 UnitedHealth Group
- 16.3.10.1 Company Overview
- 16.3.10.2 Product Portfolio
- 16.3.10.3 Financials
- 16.3.10.4 SWOT Analysis
- 16.3.11 Wipro Ltd.
- 16.3.11.1 Company Overview
- 16.3.11.2 Product Portfolio
- 16.3.11.3 Financials
- 16.3.1 CGI Inc.
Product Code: SR112023A5536
List of Figures
- Figure 1: Global: Healthcare Fraud Detection Market: Major Drivers and Challenges
- Figure 2: Global: Healthcare Fraud Detection Market: Sales Value (in Billion US$), 2017-2022
- Figure 3: Global: Healthcare Fraud Detection Market Forecast: Sales Value (in Billion US$), 2023-2028
- Figure 4: Global: Healthcare Fraud Detection Market: Breakup by Component (in %), 2022
- Figure 5: Global: Healthcare Fraud Detection Market: Breakup by Type (in %), 2022
- Figure 6: Global: Healthcare Fraud Detection Market: Breakup by Delivery Mode (in %), 2022
- Figure 7: Global: Healthcare Fraud Detection Market: Breakup by Application (in %), 2022
- Figure 8: Global: Healthcare Fraud Detection Market: Breakup by End User (in %), 2022
- Figure 9: Global: Healthcare Fraud Detection Market: Breakup by Region (in %), 2022
- Figure 10: Global: Healthcare Fraud Detection (Software) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 11: Global: Healthcare Fraud Detection (Software) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 12: Global: Healthcare Fraud Detection (Services) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 13: Global: Healthcare Fraud Detection (Services) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 14: Global: Healthcare Fraud Detection (Descriptive Analytics) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 15: Global: Healthcare Fraud Detection (Descriptive Analytics) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 16: Global: Healthcare Fraud Detection (Predictive Analytics) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 17: Global: Healthcare Fraud Detection (Predictive Analytics) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 18: Global: Healthcare Fraud Detection (Prescriptive Analytics) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 19: Global: Healthcare Fraud Detection (Prescriptive Analytics) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 20: Global: Healthcare Fraud Detection (On-premises) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 21: Global: Healthcare Fraud Detection (On-premises) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 22: Global: Healthcare Fraud Detection (On-demand) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 23: Global: Healthcare Fraud Detection (On-demand) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 24: Global: Healthcare Fraud Detection (Insurance Claims Review) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 25: Global: Healthcare Fraud Detection (Insurance Claims Review) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 26: Global: Healthcare Fraud Detection (Payment Integrity) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 27: Global: Healthcare Fraud Detection (Payment Integrity) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 28: Global: Healthcare Fraud Detection (Private Insurance Payers) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 29: Global: Healthcare Fraud Detection (Private Insurance Payers) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 30: Global: Healthcare Fraud Detection (Government Agencies) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 31: Global: Healthcare Fraud Detection (Government Agencies) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 32: Global: Healthcare Fraud Detection (Other End Users) Market: Sales Value (in Million US$), 2017 & 2022
- Figure 33: Global: Healthcare Fraud Detection (Other End Users) Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 34: North America: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 35: North America: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 36: United States: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 37: United States: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 38: Canada: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 39: Canada: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 40: Asia-Pacific: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 41: Asia-Pacific: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 42: China: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 43: China: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 44: Japan: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 45: Japan: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 46: India: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 47: India: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 48: South Korea: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 49: South Korea: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 50: Australia: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 51: Australia: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 52: Indonesia: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 53: Indonesia: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 54: Others: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 55: Others: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 56: Europe: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 57: Europe: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 58: Germany: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 59: Germany: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 60: France: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 61: France: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 62: United Kingdom: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 63: United Kingdom: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 64: Italy: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 65: Italy: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 66: Spain: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 67: Spain: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 68: Russia: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 69: Russia: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 70: Others: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 71: Others: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 72: Latin America: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 73: Latin America: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 74: Brazil: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 75: Brazil: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 76: Mexico: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 77: Mexico: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 78: Others: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 79: Others: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 80: Middle East and Africa: Healthcare Fraud Detection Market: Sales Value (in Million US$), 2017 & 2022
- Figure 81: Middle East and Africa: Healthcare Fraud Detection Market: Breakup by Country (in %), 2022
- Figure 82: Middle East and Africa: Healthcare Fraud Detection Market Forecast: Sales Value (in Million US$), 2023-2028
- Figure 83: Global: Healthcare Fraud Detection Industry: SWOT Analysis
- Figure 84: Global: Healthcare Fraud Detection Industry: Value Chain Analysis
- Figure 85: Global: Healthcare Fraud Detection Industry: Porter's Five Forces Analysis
List of Tables
- Table 1: Global: Healthcare Fraud Detection Market: Key Industry Highlights, 2022 and 2028
- Table 2: Global: Healthcare Fraud Detection Market Forecast: Breakup by Component (in Million US$), 2023-2028
- Table 3: Global: Healthcare Fraud Detection Market Forecast: Breakup by Type (in Million US$), 2023-2028
- Table 4: Global: Healthcare Fraud Detection Market Forecast: Breakup by Delivery Mode (in Million US$), 2023-2028
- Table 5: Global: Healthcare Fraud Detection Market Forecast: Breakup by Application (in Million US$), 2023-2028
- Table 6: Global: Healthcare Fraud Detection Market Forecast: Breakup by End User (in Million US$), 2023-2028
- Table 7: Global: Healthcare Fraud Detection Market Forecast: Breakup by Region (in Million US$), 2023-2028
- Table 8: Global: Healthcare Fraud Detection Market: Competitive Structure
- Table 9: Global: Healthcare Fraud Detection Market: Key Players
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