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 Healthcare Fraud Detection Market.
The Healthcare Fraud Detection Market is segmented based on solution type, delivery model, application, and end user. Based on the solution type, the descriptive analytics segment accounted for the largest share of the market in 2019. Descriptive analytics forms the base for the effective application of predictive or prescriptive analytics. Hence, these analytics use the basics of descriptive analytics and integrate them with additional sources of data in order to produce meaningful insights.
By application, the insurance claims review segment accounted for the largest share of the Healthcare Fraud Detection Market in 2019
On the basis of application, the Healthcare Fraud Analytics Solutions Market is segmented into insurance claims review, pharmacy billing misuse, payment integrity, and other applications. In 2019, the insurance claims review segment dominated the healthcare fraud analytics market. The increasing number of patients seeking health insurance, the rising number of fraudulent claims, and the growing adoption of the prepayment review model are expected to drive the growth of this segment in the coming years.
North America will dominate the healthcare fraud analytics market from 2020–2025
Geographically, the global healthcare fraud detection market is segmented into North America, Europe, the Asia Pacific, Latin America, and the Middle East and Africa. North America accounted for the largest share of the market in 2019. The high share of the North American market is attributed to the large number of people having health insurance, growing healthcare fraud, favorable government anti-fraud initiatives, the pressure to reduce healthcare costs, technological advancements, and greater product and service availability in this region.
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The key players operating in the global Healthcare Fraud Analytics Market are International Business Machines Corporation (IBM) (US), Optum, Inc. (Optum) (US), SAS Institute, Inc. (SAS) (US), Change Healthcare(US), EXL Service Holdings, Inc. (EXL) (US), Cotiviti (US), Wipro Limited (Wipro) (India), Conduent, Inc. (Conduent) (US), Hindustan Computers Limited Technologies Limited (HCL) (India), Canadian Global Information Technology Group Inc. (CGI) (Canada), DXC Technology Company (DXC) (US), Northrop Grumman Corporation (Northrop Grumman) (US), LexisNexis Group (LexisNexis) (US), Pondera Solutions (Pondera) (US), WhiteHatAI (US), Healthcare Fraud Shield (US), FraudLens (US), HMS (US), and FraudScope (US).
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