Global Healthcare Fraud Detection Market 2025-2029

Description

List of Tables

The healthcare fraud detection market is forecasted to grow by USD 1,092.1 mn during 2024-2029, accelerating at a CAGR of 11.8% during the forecast period. The report on the healthcare fraud detection market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.

The report offers an up-to-date analysis regarding the current market scenario, the latest trends and drivers, and the overall market environment. The market is driven by increased number of patients seeking health insurance, increasing cases of healthcare fraud, and rise in number of health care bpo and fraud identity management software.

Market Scope
Base Year	2025
End Year	2029
Series Year	2025-2029
Growth Momentum	Accelerate
YOY 2025	10.3%
CAGR	11.8%
Incremental Value	$1,092.1 mn

The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market size data, segment with regional analysis and vendor landscape in addition to an analysis of the key companies. Reports have historic and forecast data.

Technavio's healthcare fraud detection market is segmented as below:

By Type

Descriptive analytics
Predictive analytics
Prescriptive analytics

By End-user

Private insurance payers
Third-party administrators (TPAs)
Government agencies
Hospitals and healthcare providers

By Delivery Mode

Cloud-based
On-premises

By Geographical Landscape

North America
Asia
Europe
Rest of World (ROW)

This study identifies the emergence of social media and its impact on healthcare industry as one of the prime reasons driving the healthcare fraud detection market growth during the next few years. Also, increasing favorable government initiatives and increase in cloud-based solutions for fraud detection will lead to sizable demand in the market.

The report on the healthcare fraud detection market covers the following areas:

Healthcare Fraud Detection Market sizing
Healthcare Fraud Detection Market forecast
Healthcare Fraud Detection Market industry analysis

The robust vendor analysis is designed to help clients improve their market position, and in line with this, this report provides a detailed analysis of several leading healthcare fraud detection market vendors that include CGI Inc., Change Healthcare Inc., Codoxo, Conduent Inc., Cotiviti Inc., ExlService Holdings Inc., Fair Isaac Corp., FraudLens, H2O.ai Inc., HCL Technologies Ltd., Healthcare Fraud Shield, International Business Machines Corp., Optum Inc., OSP, Qlarant Quality Solutions Inc., SAS Institute Inc., Thomson Reuters Corp., and Wipro Ltd.. Also, the healthcare fraud detection market analysis report includes information on upcoming trends and challenges that will influence market growth. This is to help companies strategize and leverage all forthcoming growth opportunities.

The publisher presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive primary and secondary research. The market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.

Product Code: IRTNTR71895

1 Executive Summary

1.1 Market overview
- Executive Summary - Chart on Market Overview
- Executive Summary - Data Table on Market Overview
- Executive Summary - Chart on Global Market Characteristics
- Executive Summary - Chart on Market By Geographical Landscape
- Executive Summary - Chart on Market Segmentation by Type
- Executive Summary - Chart on Market Segmentation by End-user
- Executive Summary - Chart on Market Segmentation by Delivery Mode
- Executive Summary - Chart on Incremental Growth
- Executive Summary - Data Table on Incremental Growth
- Executive Summary - Chart on Company Market Positioning

2 Technavio Analysis

2.1 Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
- Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
2.2 Criticality of inputs and Factors of differentiation
- Overview on criticality of inputs and factors of differentiation
2.3 Factors of disruption
- Overview on factors of disruption
2.4 Impact of drivers and challenges
- Impact of drivers and challenges in 2024 and 2029

3 Market Landscape

3.1 Market ecosystem
- Parent Market
- Data Table on - Parent Market
3.2 Market characteristics
- Market characteristics analysis
3.3 Value chain analysis
- Value chain analysis

4 Market Sizing

4.1 Market definition
- Offerings of companies included in the market definition
4.2 Market segment analysis
- Market segments
4.3 Market size 2024
4.4 Market outlook: Forecast for 2024-2029
- Chart on Global - Market size and forecast 2024-2029 ($ million)
- Data Table on Global - Market size and forecast 2024-2029 ($ million)
- Chart on Global Market: Year-over-year growth 2024-2029 (%)
- Data Table on Global Market: Year-over-year growth 2024-2029 (%)

5 Historic Market Size

5.1 Global Healthcare Fraud Detection Market 2019 - 2023
- Historic Market Size - Data Table on Global Healthcare Fraud Detection Market 2019 - 2023 ($ million)
5.2 Type segment analysis 2019 - 2023
- Historic Market Size - Type Segment 2019 - 2023 ($ million)
5.3 End-user segment analysis 2019 - 2023
- Historic Market Size - End-user Segment 2019 - 2023 ($ million)
5.4 Delivery Mode segment analysis 2019 - 2023
- Historic Market Size - Delivery Mode Segment 2019 - 2023 ($ million)
5.5 Geography segment analysis 2019 - 2023
- Historic Market Size - Geography Segment 2019 - 2023 ($ million)
5.6 Country segment analysis 2019 - 2023
- Historic Market Size - Country Segment 2019 - 2023 ($ million)

6 Qualitative Analysis

6.1 The AI impact on Global Healthcare Fraud Detection Market

7 Five Forces Analysis

7.1 Five forces summary
- Five forces analysis - Comparison between 2024 and 2029
7.2 Bargaining power of buyers
- Bargaining power of buyers - Impact of key factors 2024 and 2029
7.3 Bargaining power of suppliers
- Bargaining power of suppliers - Impact of key factors in 2024 and 2029
7.4 Threat of new entrants
- Threat of new entrants - Impact of key factors in 2024 and 2029
7.5 Threat of substitutes
- Threat of substitutes - Impact of key factors in 2024 and 2029
7.6 Threat of rivalry
- Threat of rivalry - Impact of key factors in 2024 and 2029
7.7 Market condition
- Chart on Market condition - Five forces 2024 and 2029

8 Market Segmentation by Type

8.1 Market segments
- Chart on Type - Market share 2024-2029 (%)
- Data Table on Type - Market share 2024-2029 (%)
8.2 Comparison by Type
- Chart on Comparison by Type
- Data Table on Comparison by Type
8.3 Descriptive analytics - Market size and forecast 2024-2029
- Chart on Descriptive analytics - Market size and forecast 2024-2029 ($ million)
- Data Table on Descriptive analytics - Market size and forecast 2024-2029 ($ million)
- Chart on Descriptive analytics - Year-over-year growth 2024-2029 (%)
- Data Table on Descriptive analytics - Year-over-year growth 2024-2029 (%)
8.4 Predictive analytics - Market size and forecast 2024-2029
- Chart on Predictive analytics - Market size and forecast 2024-2029 ($ million)
- Data Table on Predictive analytics - Market size and forecast 2024-2029 ($ million)
- Chart on Predictive analytics - Year-over-year growth 2024-2029 (%)
- Data Table on Predictive analytics - Year-over-year growth 2024-2029 (%)
8.5 Prescriptive analytics - Market size and forecast 2024-2029
- Chart on Prescriptive analytics - Market size and forecast 2024-2029 ($ million)
- Data Table on Prescriptive analytics - Market size and forecast 2024-2029 ($ million)
- Chart on Prescriptive analytics - Year-over-year growth 2024-2029 (%)
- Data Table on Prescriptive analytics - Year-over-year growth 2024-2029 (%)
8.6 Market opportunity by Type
- Market opportunity by Type ($ million)
- Data Table on Market opportunity by Type ($ million)

9 Market Segmentation by End-user

9.1 Market segments
- Chart on End-user - Market share 2024-2029 (%)
- Data Table on End-user - Market share 2024-2029 (%)
9.2 Comparison by End-user
- Chart on Comparison by End-user
- Data Table on Comparison by End-user
9.3 Private insurance payers - Market size and forecast 2024-2029
- Chart on Private insurance payers - Market size and forecast 2024-2029 ($ million)
- Data Table on Private insurance payers - Market size and forecast 2024-2029 ($ million)
- Chart on Private insurance payers - Year-over-year growth 2024-2029 (%)
- Data Table on Private insurance payers - Year-over-year growth 2024-2029 (%)
9.4 Third-party administrators (TPAs) - Market size and forecast 2024-2029
- Chart on Third-party administrators (TPAs) - Market size and forecast 2024-2029 ($ million)
- Data Table on Third-party administrators (TPAs) - Market size and forecast 2024-2029 ($ million)
- Chart on Third-party administrators (TPAs) - Year-over-year growth 2024-2029 (%)
- Data Table on Third-party administrators (TPAs) - Year-over-year growth 2024-2029 (%)
9.5 Government agencies - Market size and forecast 2024-2029
- Chart on Government agencies - Market size and forecast 2024-2029 ($ million)
- Data Table on Government agencies - Market size and forecast 2024-2029 ($ million)
- Chart on Government agencies - Year-over-year growth 2024-2029 (%)
- Data Table on Government agencies - Year-over-year growth 2024-2029 (%)
9.6 Hospitals and healthcare providers - Market size and forecast 2024-2029
- Chart on Hospitals and healthcare providers - Market size and forecast 2024-2029 ($ million)
- Data Table on Hospitals and healthcare providers - Market size and forecast 2024-2029 ($ million)
- Chart on Hospitals and healthcare providers - Year-over-year growth 2024-2029 (%)
- Data Table on Hospitals and healthcare providers - Year-over-year growth 2024-2029 (%)
9.7 Market opportunity by End-user
- Market opportunity by End-user ($ million)
- Data Table on Market opportunity by End-user ($ million)

10 Market Segmentation by Delivery Mode

10.1 Market segments
- Chart on Delivery Mode - Market share 2024-2029 (%)
- Data Table on Delivery Mode - Market share 2024-2029 (%)
10.2 Comparison by Delivery Mode
- Chart on Comparison by Delivery Mode
- Data Table on Comparison by Delivery Mode
10.3 Cloud-based - Market size and forecast 2024-2029
- Chart on Cloud-based - Market size and forecast 2024-2029 ($ million)
- Data Table on Cloud-based - Market size and forecast 2024-2029 ($ million)
- Chart on Cloud-based - Year-over-year growth 2024-2029 (%)
- Data Table on Cloud-based - Year-over-year growth 2024-2029 (%)
10.4 On-premises - Market size and forecast 2024-2029
- Chart on On-premises - Market size and forecast 2024-2029 ($ million)
- Data Table on On-premises - Market size and forecast 2024-2029 ($ million)
- Chart on On-premises - Year-over-year growth 2024-2029 (%)
- Data Table on On-premises - Year-over-year growth 2024-2029 (%)
10.5 Market opportunity by Delivery Mode
- Market opportunity by Delivery Mode ($ million)
- Data Table on Market opportunity by Delivery Mode ($ million)

11 Customer Landscape

11.1 Customer landscape overview
- Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria

12 Geographic Landscape

12.1 Geographic segmentation
- Chart on Market share By Geographical Landscape 2024-2029 (%)
- Data Table on Market share By Geographical Landscape 2024-2029 (%)
12.2 Geographic comparison
- Chart on Geographic comparison
- Data Table on Geographic comparison
12.3 North America - Market size and forecast 2024-2029
- Chart on North America - Market size and forecast 2024-2029 ($ million)
- Data Table on North America - Market size and forecast 2024-2029 ($ million)
- Chart on North America - Year-over-year growth 2024-2029 (%)
- Data Table on North America - Year-over-year growth 2024-2029 (%)
12.4 Asia - Market size and forecast 2024-2029
- Chart on Asia - Market size and forecast 2024-2029 ($ million)
- Data Table on Asia - Market size and forecast 2024-2029 ($ million)
- Chart on Asia - Year-over-year growth 2024-2029 (%)
- Data Table on Asia - Year-over-year growth 2024-2029 (%)
12.5 Europe - Market size and forecast 2024-2029
- Chart on Europe - Market size and forecast 2024-2029 ($ million)
- Data Table on Europe - Market size and forecast 2024-2029 ($ million)
- Chart on Europe - Year-over-year growth 2024-2029 (%)
- Data Table on Europe - Year-over-year growth 2024-2029 (%)
12.6 Rest of World (ROW) - Market size and forecast 2024-2029
- Chart on Rest of World (ROW) - Market size and forecast 2024-2029 ($ million)
- Data Table on Rest of World (ROW) - Market size and forecast 2024-2029 ($ million)
- Chart on Rest of World (ROW) - Year-over-year growth 2024-2029 (%)
- Data Table on Rest of World (ROW) - Year-over-year growth 2024-2029 (%)
12.7 US - Market size and forecast 2024-2029
- Chart on US - Market size and forecast 2024-2029 ($ million)
- Data Table on US - Market size and forecast 2024-2029 ($ million)
- Chart on US - Year-over-year growth 2024-2029 (%)
- Data Table on US - Year-over-year growth 2024-2029 (%)
12.8 Canada - Market size and forecast 2024-2029
- Chart on Canada - Market size and forecast 2024-2029 ($ million)
- Data Table on Canada - Market size and forecast 2024-2029 ($ million)
- Chart on Canada - Year-over-year growth 2024-2029 (%)
- Data Table on Canada - Year-over-year growth 2024-2029 (%)
12.9 China - Market size and forecast 2024-2029
- Chart on China - Market size and forecast 2024-2029 ($ million)
- Data Table on China - Market size and forecast 2024-2029 ($ million)
- Chart on China - Year-over-year growth 2024-2029 (%)
- Data Table on China - Year-over-year growth 2024-2029 (%)
12.10 Mexico - Market size and forecast 2024-2029
- Chart on Mexico - Market size and forecast 2024-2029 ($ million)
- Data Table on Mexico - Market size and forecast 2024-2029 ($ million)
- Chart on Mexico - Year-over-year growth 2024-2029 (%)
- Data Table on Mexico - Year-over-year growth 2024-2029 (%)
12.11 Germany - Market size and forecast 2024-2029
- Chart on Germany - Market size and forecast 2024-2029 ($ million)
- Data Table on Germany - Market size and forecast 2024-2029 ($ million)
- Chart on Germany - Year-over-year growth 2024-2029 (%)
- Data Table on Germany - Year-over-year growth 2024-2029 (%)
12.12 India - Market size and forecast 2024-2029
- Chart on India - Market size and forecast 2024-2029 ($ million)
- Data Table on India - Market size and forecast 2024-2029 ($ million)
- Chart on India - Year-over-year growth 2024-2029 (%)
- Data Table on India - Year-over-year growth 2024-2029 (%)
12.13 UK - Market size and forecast 2024-2029
- Chart on UK - Market size and forecast 2024-2029 ($ million)
- Data Table on UK - Market size and forecast 2024-2029 ($ million)
- Chart on UK - Year-over-year growth 2024-2029 (%)
- Data Table on UK - Year-over-year growth 2024-2029 (%)
12.14 Brazil - Market size and forecast 2024-2029
- Chart on Brazil - Market size and forecast 2024-2029 ($ million)
- Data Table on Brazil - Market size and forecast 2024-2029 ($ million)
- Chart on Brazil - Year-over-year growth 2024-2029 (%)
- Data Table on Brazil - Year-over-year growth 2024-2029 (%)
12.15 Japan - Market size and forecast 2024-2029
- Chart on Japan - Market size and forecast 2024-2029 ($ million)
- Data Table on Japan - Market size and forecast 2024-2029 ($ million)
- Chart on Japan - Year-over-year growth 2024-2029 (%)
- Data Table on Japan - Year-over-year growth 2024-2029 (%)
12.16 France - Market size and forecast 2024-2029
- Chart on France - Market size and forecast 2024-2029 ($ million)
- Data Table on France - Market size and forecast 2024-2029 ($ million)
- Chart on France - Year-over-year growth 2024-2029 (%)
- Data Table on France - Year-over-year growth 2024-2029 (%)
12.17 Market opportunity By Geographical Landscape
- Market opportunity By Geographical Landscape ($ million)
- Data Tables on Market opportunity By Geographical Landscape ($ million)

13 Drivers, Challenges, and Opportunity/Restraints

13.1 Market drivers
13.2 Market challenges
13.3 Impact of drivers and challenges
- Impact of drivers and challenges in 2024 and 2029
13.4 Market opportunities/restraints

14 Competitive Landscape

14.1 Overview
14.2 Competitive Landscape
- Overview on criticality of inputs and factors of differentiation
14.3 Landscape disruption
- Overview on factors of disruption
14.4 Industry risks
- Impact of key risks on business

15 Competitive Analysis

15.1 Companies profiled
- Companies covered
15.2 Company ranking index
- Company ranking index
15.3 Market positioning of companies
- Matrix on companies position and classification
15.4 CGI Inc.
- CGI Inc. - Overview
- CGI Inc. - Business segments
- CGI Inc. - Key news
- CGI Inc. - Key offerings
- CGI Inc. - Segment focus
- SWOT
15.5 Change Healthcare Inc.
- Change Healthcare Inc. - Overview
- Change Healthcare Inc. - Product / Service
- Change Healthcare Inc. - Key offerings
- SWOT
15.6 Conduent Inc.
- Conduent Inc. - Overview
- Conduent Inc. - Business segments
- Conduent Inc. - Key offerings
- Conduent Inc. - Segment focus
- SWOT
15.7 Cotiviti Inc.
- Cotiviti Inc. - Overview
- Cotiviti Inc. - Product / Service
- Cotiviti Inc. - Key offerings
- SWOT
15.8 ExlService Holdings Inc.
- ExlService Holdings Inc. - Overview
- ExlService Holdings Inc. - Business segments
- ExlService Holdings Inc. - Key offerings
- ExlService Holdings Inc. - Segment focus
- SWOT
15.9 Fair Isaac Corp.
- Fair Isaac Corp. - Overview
- Fair Isaac Corp. - Business segments
- Fair Isaac Corp. - Key news
- Fair Isaac Corp. - Key offerings
- Fair Isaac Corp. - Segment focus
- SWOT
15.10 H2O.ai Inc.
- H2O.ai Inc. - Overview
- H2O.ai Inc. - Product / Service
- H2O.ai Inc. - Key offerings
- SWOT
15.11 HCL Technologies Ltd.
- HCL Technologies Ltd. - Overview
- HCL Technologies Ltd. - Business segments
- HCL Technologies Ltd. - Key news
- HCL Technologies Ltd. - Key offerings
- HCL Technologies Ltd. - Segment focus
- SWOT
15.12 Healthcare Fraud Shield
- Healthcare Fraud Shield - Overview
- Healthcare Fraud Shield - Product / Service
- Healthcare Fraud Shield - Key offerings
- SWOT
15.13 International Business Machines Corp.
- International Business Machines Corp. - Overview
- International Business Machines Corp. - Business segments
- International Business Machines Corp. - Key news
- International Business Machines Corp. - Key offerings
- International Business Machines Corp. - Segment focus
- SWOT
15.14 Optum Inc.
- Optum Inc. - Overview
- Optum Inc. - Product / Service
- Optum Inc. - Key offerings
- SWOT
15.15 Qlarant Quality Solutions Inc.
- Qlarant Quality Solutions Inc. - Overview
- Qlarant Quality Solutions Inc. - Product / Service
- Qlarant Quality Solutions Inc. - Key offerings
- SWOT
15.16 SAS Institute Inc.
- SAS Institute Inc. - Overview
- SAS Institute Inc. - Product / Service
- SAS Institute Inc. - Key news
- SAS Institute Inc. - Key offerings
- SWOT
15.17 Thomson Reuters Corp.
- Thomson Reuters Corp. - Overview
- Thomson Reuters Corp. - Business segments
- Thomson Reuters Corp. - Key news
- Thomson Reuters Corp. - Key offerings
- Thomson Reuters Corp. - Segment focus
- SWOT
15.18 Wipro Ltd.
- Wipro Ltd. - Overview
- Wipro Ltd. - Business segments
- Wipro Ltd. - Key news
- Wipro Ltd. - Key offerings
- Wipro Ltd. - Segment focus
- SWOT

16 Appendix

16.1 Scope of the report
16.2 Inclusions and exclusions checklist
- Inclusions checklist
- Exclusions checklist
16.3 Currency conversion rates for US$
- Currency conversion rates for US$
16.4 Research methodology
- Research methodology
16.5 Data procurement
- Information sources
16.6 Data validation
- Data validation
16.7 Validation techniques employed for market sizing
- Validation techniques employed for market sizing
16.8 Data synthesis
- Data synthesis
16.9 360 degree market analysis
- 360 degree market analysis
16.10 List of abbreviations
- List of abbreviations