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Market Research Report

North America Healthcare Fraud Analytics and Detection Market Forecast 2020-2028

Published by Inkwood Research Product code 943449
Published Content info 120 Pages
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North America Healthcare Fraud Analytics and Detection Market Forecast 2020-2028
Published: June 21, 2020 Content info: 120 Pages
Description

KEY FINDINGS

The North America healthcare fraud analytics and detection market is set to project a CAGR of 21.06% during the forecast period, 2020-2028. Several government initiatives and the increasing awareness regarding healthcare frauds are contributing to the growth of the market in the region.

MARKET INSIGHTS

Canada and the United States are the countries analyzed in the North America healthcare fraud analytics and detection market for growth analysis. The Canadian government established the Public Health Agency of Canada in 2004 to keep a check on public health. The agency is responsible for several strategies and programs that are undertaken and executed for enhancing the public healthcare system. Healthcare expenditure is on the rise in the country. There is the presence of The Canadian Life and Health Insurance Association (CLHIA), which is increasing consumer awareness and education, with regard to health and dental benefits fraud through the Fraud=Fraud campaign. The organization also holds a considerable amount of assets. According to the CLHIA, fraudulent claims vary from 2% to 10% every year. As a result, the rising awareness created by the associations, and the increasing cases of healthcare frauds, are projected to result in a huge demand for healthcare fraud detection solutions in the forthcoming years. Such factors are set to contribute to the growth of the market.

COMPETITIVE INSIGHTS

Some of the well-established companies in the market include, CGI Inc, IBM, McKesson, Northrop Grumman, United Health Group Incorporated (Optum Inc), etc.

Our report offerings include:

  • Explore key findings of the overall market
  • Strategic breakdown of market dynamics (Drivers, Restraints, Opportunities, Challenges)
  • Market forecasts for a minimum of 9 years, along with 3 years of historical data for all segments, sub-segments, and regions
  • Market Segmentation cater to a thorough assessment of key segments with their market estimations
  • Geographical Analysis: Assessments of the mentioned regions and country-level segments with their market share
  • Key analytics: Porter's Five Forces Analysis, Vendor Landscape, Opportunity Matrix, Key Buying Criteria, etc.
  • Competitive landscape is the theoretical explanation of the key companies based on factors, market share, etc.
  • Company profiling: A detailed company overview, product/services offered, SCOT analysis, and recent strategic developments
Table of Contents
Product Code: 32290

TABLE OF CONTENTS

1. RESEARCH SCOPE & METHODOLOGY

  • 1.1. STUDY OBJECTIVES
  • 1.2. SCOPE OF STUDY
  • 1.3. METHODOLOGY
  • 1.4. ASSUMPTIONS & LIMITATIONS

2. EXECUTIVE SUMMARY

  • 2.1. MARKET SIZE & ESTIMATES
  • 2.2. MARKET OVERVIEW

3. MARKET DYNAMICS

  • 3.1. MARKET DEFINITION
  • 3.2. KEY DRIVERS
    • 3.2.1. RISE IN HEALTHCARE EXPENDITURE
    • 3.2.2. SURGE IN THE NUMBER OF PATIENTS OPTING FOR HEALTH INSURANCE
    • 3.2.3. RISE IN FABRICATED ACTIVITIES IN HEALTHCARE
  • 3.3. KEY RESTRAINTS
    • 3.3.1. RELUCTANCE TO ADOPT HEALTHCARE FRAUD ANALYTICS

4. KEY ANALYTICS

  • 4.1. KEY INVESTMENT INSIGHTS
  • 4.2. PORTER'S FIVE FORCE ANALYSIS
    • 4.2.1. BUYER POWER
    • 4.2.2. SUPPLIER POWER
    • 4.2.3. SUBSTITUTION
    • 4.2.4. NEW ENTRANTS
    • 4.2.5. INDUSTRY RIVALRY
  • 4.3. OPPORTUNITY MATRIX
  • 4.4. VENDOR LANDSCAPE

5. MARKET BY TYPE

  • 5.1. DESCRIPTIVE ANALYSIS
  • 5.2. PREDICTIVE ANALYSIS
  • 5.3. PRESCRIPTIVE ANALYSIS

6. MARKET BY APPLICATION

  • 6.1. REVIEW OF INSURANCE CLAIMS
  • 6.2. PAYMENT INTEGRITY

7. MARKET BY END-USER

  • 7.1. PRIVATE INSURANCE PAYERS
  • 7.2. GOVERNMENT AGENCIES
  • 7.3. OTHER END-USERS

8. GEOGRAPHICAL ANALYSIS

  • 8.1. NORTH AMERICA
    • 8.1.1. UNITED STATES
    • 8.1.2. CANADA

9. COMPANY PROFILES

  • 9.1. CGI INC
  • 9.2. DXC TECHNOLOGY
  • 9.3. EXL
  • 9.4. IBM
  • 9.5. MCKESSON
  • 9.6. NORTHROP GRUMMAN
  • 9.7. OSP LABS
  • 9.8. SAS INSTITUTE
  • 9.9. RELX GROUP PLC
  • 9.10. UNITED HEALTH GROUP INCORPORATED (OPTUM INC)
  • 9.11. COTIVITI HOLDINGS INC
  • 9.12. CHANGE HEALTHCARE
  • 9.13. FAIR ISSAC CORPORATION
  • 9.14. PONDERA SOLUTIONS

LIST OF TABLES

  • TABLE 1: MARKET SNAPSHOT - HEALTHCARE FRAUD ANALYTICS AND DETECTION
  • TABLE 2: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY TYPE, HISTORICAL YEARS, 2016-2019 (IN $ MILLION)
  • TABLE 3: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY TYPE, FORECAST YEARS, 2020-2028 (IN $ MILLION)
  • TABLE 4: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY APPLICATION, HISTORICAL YEARS, 2016-2019 (IN $ MILLION)
  • TABLE 5: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY APPLICATION, FORECAST YEARS, 2020-2028 (IN $ MILLION)
  • TABLE 6: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY END-USER, HISTORICAL YEARS, 2016-2019 (IN $ MILLION)
  • TABLE 7: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY END-USER, FORECAST YEARS, 2020-2028 (IN $ MILLION)
  • TABLE 8: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY COUNTRY, HISTORICAL YEARS, 2016-2019 (IN $ MILLION)
  • TABLE 9: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY COUNTRY, FORECAST YEARS, 2020-2028 (IN $ MILLION)

LIST OF FIGURES

  • FIGURE 1: KEY INVESTMENT INSIGHTS
  • FIGURE 2: PORTER'S FIVE FORCE ANALYSIS
  • FIGURE 3: OPPORTUNITY MATRIX
  • FIGURE 4: VENDOR LANDSCAPE
  • FIGURE 5: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, GROWTH POTENTIAL, BY TYPE, IN 2019
  • FIGURE 6: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY DESCRIPTIVE ANALYSIS, 2020-2028 (IN $ MILLION)
  • FIGURE 7: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PREDICTIVE ANALYSIS, 2020-2028 (IN $ MILLION)
  • FIGURE 8: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PRESCRIPTIVE ANALYSIS, 2020-2028 (IN $ MILLION)
  • FIGURE 9: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, GROWTH POTENTIAL, BY APPLICATION, IN 2019
  • FIGURE 10: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY REVIEW OF INSURANCE CLAIMS, 2020-2028 (IN $ MILLION)
  • FIGURE 11: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PAYMENT INTEGRITY, 2020-2028 (IN $ MILLION)
  • FIGURE 12: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, GROWTH POTENTIAL, BY END-USER, IN 2019
  • FIGURE 13: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY PRIVATE INSURANCE PAYERS, 2020-2028 (IN $ MILLION)
  • FIGURE 14: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY GOVERNMENT AGENCIES, 2020-2028 (IN $ MILLION)
  • FIGURE 15: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, BY OTHER END-USERS, 2020-2028 (IN $ MILLION)
  • FIGURE 16: NORTH AMERICA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, REGIONAL OUTLOOK, 2019 & 2028 (IN %)
  • FIGURE 17: UNITED STATES HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2020-2028 (IN $ MILLION)
  • FIGURE 18: CANADA HEALTHCARE FRAUD ANALYTICS AND DETECTION MARKET, 2020-2028 (IN $ MILLION)
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