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% during the forecast period.
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 prescriptive analytics segment registered the highest growth during the forecast period.
Fraud analytics solutions vary from vendor to vendor. Some vendors offer rule-based models while others offer AI-based technologies, but broadly, these solutions are classified based on the type of analytics used—descriptive analytics, predictive analytics, and prescriptive analytics.
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In 2019, public & government agencies accounted for the largest share of the healthcare fraud analytics market, by end user.
Based on end user, the healthcare fraud detection market is segmented into public & government agencies, private insurance payers, employers, and third-party service providers. The public & government agencies segment accounted for the largest share of the healthcare fraud analytics market in 2019.
North America dominated the market in 2019
North America accounted for the largest share of the healthcare fraud analytics market in 2019, followed by Europe. Factors such as the high number of cases of healthcare fraud, including pharmacy-related fraud, favorable government initiatives, technological advancements, and the availability of solutions in this region are some factors contributing to North America’s large share in the global healthcare fraud analytics space.
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Leading Companies
IBM Corporation (US), Optum (US), SAS Institute (US), Change Healthcare (US), EXL Service Holdings (US), Cotiviti (US), Wipro Limited (Wipro) (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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