Healthcare Fraud Analytics Market Size, Share & Growth Analysis 2022-2028 : Preventing Healthcare Fraud Using Predictive Modelling Technology

The Healthcare Fraud Analytics Market Size was valued at US$ 1.69 billion in 2021 and is projected to reach at US$ 7.79 billion by 2028, with a healthy CAGR of 24.2%.

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Pune, Maharashtra — (SBWIRE) — 07/19/2022 — Healthcare Fraud Analytics Market 2022 Overview:

Numerous incidents of fraud committed by patients, doctors, physicians, and other medical specialists have been reported in the healthcare sector. There have been numerous reports of medical professionals engaging in fraudulent behavior for financial gain. Patients who commit fraud in the healthcare industry often obtain fake medical records, falsify prescriptions, and avoid paying for services rendered. Healthcare fraud analytics refers to fraud detection tools and strategies that help catch healthcare frauds such as duplicate claims, claim submission mistakes, health insurance frauds, and pharmacist-committed prescription fraud early on.

As per the latest market research report by SNS Insider, the healthcare fraud analytics market is expected to reach USD 7.79 billion by 2028, with a higher CAGR of 24.2% during the forecast period of 2022–2028.

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Drivers, Restraints, Opportunities, and Challenges

The global healthcare fraud analytics market is expected to grow significantly during the anticipated period. The global increase in health insurance fraud incidences is responsible for a major portion of the market growth. The global market is also anticipated to benefit from growing government spending on the healthcare ecosystem to stop fraudulent activities throughout the projected period. The market for healthcare fraud analytics is also projected to be driven by the rising healthcare insurance sector over the forecast period.
The implementation of fraud analytics solutions takes time. Predictive models, new databases, user interface development, model evaluation and deployment, and model effectiveness monitoring are all part of the process. In this procedure, data analysts run algorithms repeatedly until they obtain the best possible predictive model. It is anticipated that major enterprises' inability to accurately integrate fraud analytics solutions and a lack of experienced specialists will constrain healthcare fraud analytics market expansion. On the other hand, the market for healthcare fraud analytics is positioned to benefit from the adoption of healthcare fraud analytics in emerging nations, the rise of social media and its effects on the healthcare sector, and the use of AI in healthcare fraud detection.

Impact of the COVID-19 Pandemic

The healthcare sector has been severely impacted by the COVID-19 outbreak. The healthcare sector has seen numerous instances of fraud committed by physicians, patients, doctors, and other healthcare professionals. Many medical professionals and healthcare providers are reportedly involved in fraudulent operations to make money. Numerous examples demonstrate the rise in fraud cases during the COVID-19 pandemic.

Healthcare Fraud Analytics Market Segmentation Analysis 2022

During the anticipated timeframe, the on-premises sector is anticipated to dominate the healthcare fraud analytics market. Solutions offered internally within a company's IT infrastructure via an on-premises deployment are crucial for controlling costs and resource utilization.

The insurance claims sub-segment has the biggest market share in terms of applicability. The rise in healthcare fraud cases, the number of patients seeking medical insurance, and the expanding use of the pre-payment assessment procedure are all driving this market's expansion.

According to projections, the predictive segment will drive the industry's growth, multiplying at a faster annual rate. The segment's expansion can be linked to predictive analytics' improved capacity to spot potentially fraudulent trends that quickly produce a large number of claims.

Major Segments and Sub-Segment of Healthcare Fraud Analytics Market are Listed Below:

By Solution Type

– Descriptive Analytics
– Prescriptive Analytics
– Predictive Analytics

By Delivery Model
– On-premises
– Cloud-based

By Application
– Insurance Claim Review
o Postpayment Review
o Prepayment Review
– Pharmacy billing Issue
– Payment Integrity
– Others

By End User
– Public & Government Agencies
– Private Insurance Payers
– Third-party Service Providers
– Employers

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Regional Analysis

North America is expected to experience the fastest market growth during the projected period due to factors including an increasing number of people seeking healthcare insurance, an increase in the number of fraudulent claims, increased government efforts to stop fraud, and an increasing need to keep healthcare costs as low as possible. Additionally, the healthcare fraud analytics market expansion is gaining momentum due to the quickening pace of technological development and the expanded availability of cutting-edge goods and services.

Competitive Landscape Outlook

Some of the prominent companies present in the healthcare fraud analytics market include EXL Service Holdings Inc., Cotiviti, Inc, Optum Inc., Conduent Inc, SAS Institute Inc., DXC Technology, Wipro Limited, and HCL Technologies Limited.

Frequently Asked Questions in this report are:

– What is the projected market size & growth rate of the Healthcare Fraud Analytics Market?
– What are the key driving factors for the growth of the Healthcare Fraud Analytics Market?
– What are the top players operating in the Healthcare Fraud Analytics Market?
– What segments are covered in the Healthcare Fraud Analytics Market report?

Table of Contents – Major key Points

1. Introduction

2. Research Methodology

3. Market Dynamics

4. Impact Analysis

5. Value Chain Analysis

6. Porter's 5 Forces Model

7. PEST Analysis

8. Healthcare Fraud Analytics Segmentation, By Solution Type

9. Healthcare Fraud Analytics Segmentation, By Delivery Model

10. Healthcare Fraud Analytics Segmentation, By Application

11. Healthcare Fraud Analytics Segmentation, By End User

12. Regional Analysis

13 Company Profiles

14 Competitive Landscape

15 Conclusion

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