Healthcare Fraud Detection Market – Overview

The escalated expenses related to healthcare services in increasing the frequency of fraud in the healthcare sector. Market reports connected with the healthcare IT industry have been presented by Market Research Future which makes reports on other industry verticals that aims to analyze the current market scenarios better. The market is anticipated to attain returns worth USD 639.07 million while expanding at a CAGR of 26.7% in the forecast period.

The detection of healthcare fraud has gained increased momentum due to the development of stringent and thorough checks in the procedure for claims. Moreover, the emphasis on reducing losses to the insurance companies is expected to fuel the development of the healthcare fraud detection market in the coming years. The need to detect linkages among seemingly unrelated claims is expected to be one of the key areas for the progress of the market.

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Competitive Analysis:

Significant reductions in administrative costs are inducing further expansion of the market. The vertical additions and product tactics of the market are boosting the potential of the market players. The development of a robust value chain is further motivating the development of the market. The strategic goals intended for the market are reinforced due to favorable product differentiation carried out by market competitors. The growth of the market is moving in a favorable direction due to new product launches or rising gross revenue of the players in the market. Increased adaptability of market players to new market trends and customers inclinations are lifting the growth curve of the market and will continue do so in the forecast period. The successful implementation of strategies is expected to motivate the market in the coming years.

The major contenders in the market are Optum, Verscend Technologies, McKesson, Fair Isaac, SAS Institute, HCL Technologies, Conduent, Wipro, LexisNexis, International Business Machines Corporation (IBM), Scio Health Analytics, CGI Group, DXC Technology, Northrop Grumman, and Pondera Solutions

Segmental Analysis:

The segmental analysis of the healthcare fraud detection market is carried out on the basis of end user, component, application, delivery model, type, and region. On the basis of component, the market has been segmented into services and software. Based on delivery model, the market has been segmented into on-demand delivery and on-premise delivery models. The segmentation on the basis of type comprises of predictive analytics, descriptive analytics, and prescriptive analytics. The descriptive segment is anticipated to direct the market on the basis of type as descriptive analytics is the base for effective application of prescriptive or predictive analytics. Based on application, the healthcare fraud detection market has been segmented into payment integrity and insurance claims review. The insurance claims review segment has been segmented into prepayment review and post-payment review. The end user basis of segmentation of the market consists of government agencies, employers, private insurance payers, and others. The regions considered in the healthcare fraud detection market are Asia Pacific, Europe, the Middle East, Americas, and Africa.

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Detailed Regional Analysis:

The regional analysis of the Healthcare Fraud Detection Market discerns that the Americas region is estimated to control the healthcare fraud detection market due to the increasing number of cases related to frauds in the healthcare sector, a mounting number of people requesting health insurance, and promising government initiatives to prevent the frauds in healthcare. The European region is anticipated to control the next principal position in the healthcare fraud detection market. The market development in this region is accredited to the increasing cases of healthcare fraud and corruption in Europe, progress of the IT sector, and developing state to reduce fraud in the healthcare sector. The healthcare fraud detection market in the Asia-Pacific region is anticipated to be the swiftest developing region in the market owing to constantly developing economies, evolving IT sector, and high frequency of frauds. The Middle Eastern and African region have the minimum share of the market. In this region, the Middle Eastern region is projected to hold a key share due to the intensifying incidences of health insurance frauds.