Report cover image

Healthcare Fraud Detection Market by Solution Type (Descriptive Analytics, Predictive Analytics, Prescriptive Analytics), Delivery Mode (On-Cloud, On-Premise), Application, End User - Global Forecast 2024-2030

Publisher 360iResearch
Published Jan 15, 2024
Length 190 Pages
SKU # IRE18444273

Description

Healthcare Fraud Detection Market by Solution Type (Descriptive Analytics, Predictive Analytics, Prescriptive Analytics), Delivery Mode (On-Cloud, On-Premise), Application, End User - Global Forecast 2024-2030


The Healthcare Fraud Detection Market size was estimated at USD 1.91 billion in 2023 and expected to reach USD 2.22 billion in 2024, at a CAGR 20.17% to reach USD 6.91 billion by 2030.

FPNV Positioning Matrix

The FPNV Positioning Matrix is pivotal in evaluating the Healthcare Fraud Detection Market. It offers a comprehensive assessment of vendors, examining key metrics related to Business Strategy and Product Satisfaction. This in-depth analysis empowers users to make well-informed decisions aligned with their requirements. Based on the evaluation, the vendors are then categorized into four distinct quadrants representing varying levels of success: Forefront (F), Pathfinder (P), Niche (N), or Vital (V).

Market Share Analysis

The Market Share Analysis is a comprehensive tool that provides an insightful and in-depth examination of the current state of vendors in the Healthcare Fraud Detection Market. By meticulously comparing and analyzing vendor contributions in terms of overall revenue, customer base, and other key metrics, we can offer companies a greater understanding of their performance and the challenges they face when competing for market share. Additionally, this analysis provides valuable insights into the competitive nature of the sector, including factors such as accumulation, fragmentation dominance, and amalgamation traits observed over the base year period studied. With this expanded level of detail, vendors can make more informed decisions and devise effective strategies to gain a competitive edge in the market.

Key Company Profiles

The report delves into recent significant developments in the Healthcare Fraud Detection Market, highlighting leading vendors and their innovative profiles. These include CGI Inc., Change Healthcare, Conduent Inc., Cotiviti Inc., DXC Technology Company, ExlService Holdings Inc., Fair Isaac Corporation, FraudLens Inc., H20.ai, HCL Technologies Limited, International Business Machines Corporation, Northrop Grumman Corporation, Optum Inc., OSP Labs, SAS Institute Inc., and Wipro Ltd..

Market Segmentation & Coverage



This research report categorizes the Healthcare Fraud Detection Market to forecast the revenues and analyze trends in each of the following sub-markets:

Solution Type
Descriptive Analytics
Predictive Analytics
Prescriptive Analytics
Delivery Mode
On-Cloud
On-Premise
Application
Insurance Claims Review
Payment Integrity
End User
Government Agencies
Healthcare Payer
Region
Americas
Argentina

Brazil

Canada

Mexico

United States
California

Florida

Illinois

New York

Ohio

Pennsylvania

Texas
Asia-Pacific
Australia

China

India

Indonesia

Japan

Malaysia

Philippines

Singapore

South Korea

Taiwan

Thailand

Vietnam
Europe, Middle East & Africa
Denmark

Egypt

Finland

France

Germany

Israel

Italy

Netherlands

Nigeria

Norway

Poland

Qatar

Russia

Saudi Arabia

South Africa

Spain

Sweden

Switzerland

Turkey

United Arab Emirates

United Kingdom

The report offers valuable insights on the following aspects:

1. Market Penetration: It presents comprehensive information on the market provided by key players.
2. Market Development: It delves deep into lucrative emerging markets and analyzes the penetration across mature market segments.
3. Market Diversification: It provides detailed information on new product launches, untapped geographic regions, recent developments, and investments.
4. Competitive Assessment & Intelligence: It conducts an exhaustive assessment of market shares, strategies, products, certifications, regulatory approvals, patent landscape, and manufacturing capabilities of the leading players.
5. Product Development & Innovation: It offers intelligent insights on future technologies, R&D activities, and breakthrough product developments.

The report addresses key questions such as:

1. What is the market size and forecast of the Healthcare Fraud Detection Market?
2. Which products, segments, applications, and areas should one consider investing in over the forecast period in the Healthcare Fraud Detection Market?
3. What are the technology trends and regulatory frameworks in the Healthcare Fraud Detection Market?
4. What is the market share of the leading vendors in the Healthcare Fraud Detection Market?
5. Which modes and strategic moves are suitable for entering the Healthcare Fraud Detection Market?

Note: PDF & Excel + Online Access - 1 Year

Table of Contents

190 Pages
1. Preface
1.1. Objectives of the Study
1.2. Market Segmentation & Coverage
1.3. Years Considered for the Study
1.4. Currency & Pricing
1.5. Language
1.6. Limitations
1.7. Assumptions
1.8. Stakeholders
2. Research Methodology
2.1. Define: Research Objective
2.2. Determine: Research Design
2.3. Prepare: Research Instrument
2.4. Collect: Data Source
2.5. Analyze: Data Interpretation
2.6. Formulate: Data Verification
2.7. Publish: Research Report
2.8. Repeat: Report Update
3. Executive Summary
4. Market Overview
4.1. Introduction
4.2. Healthcare Fraud Detection Market, by Region
5. Market Insights
5.1. Market Dynamics
5.1.1. Drivers
5.1.1.1. Increase in number of patients seeking health insurance
5.1.1.2. Rising adoption of cloud-based analytical solutions coupled with increase in fraudulent events in healthcare industry
5.1.1.3. Growing need for solutions that have biometric sensors to identify frauds
5.1.2. Restraints
5.1.2.1. Limitations in data capturing process and dearth of skilled professionals
5.1.3. Opportunities
5.1.3.1. Introduction of advanced softwares integrated with artificial intelligence and machine learning
5.1.3.2. Rise in number of healthcare BPO and fraud identity management software
5.1.4. Challenges
5.1.4.1. Need for frequent upgradation
5.2. Market Segmentation Analysis
5.3. Market Trend Analysis
5.4. Cumulative Impact of High Inflation
5.5. Porter’s Five Forces Analysis
5.5.1. Threat of New Entrants
5.5.2. Threat of Substitutes
5.5.3. Bargaining Power of Customers
5.5.4. Bargaining Power of Suppliers
5.5.5. Industry Rivalry
5.6. Value Chain & Critical Path Analysis
5.7. Regulatory Framework
6. Healthcare Fraud Detection Market, by Solution Type
6.1. Introduction
6.2. Descriptive Analytics
6.3. Predictive Analytics
6.4. Prescriptive Analytics
7. Healthcare Fraud Detection Market, by Delivery Mode
7.1. Introduction
7.2. On-Cloud
7.3. On-Premise
8. Healthcare Fraud Detection Market, by Application
8.1. Introduction
8.2. Insurance Claims Review
8.3. Payment Integrity
9. Healthcare Fraud Detection Market, by End User
9.1. Introduction
9.2. Government Agencies
9.3. Healthcare Payer
10. Americas Healthcare Fraud Detection Market
10.1. Introduction
10.2. Argentina
10.3. Brazil
10.4. Canada
10.5. Mexico
10.6. United States
11. Asia-Pacific Healthcare Fraud Detection Market
11.1. Introduction
11.2. Australia
11.3. China
11.4. India
11.5. Indonesia
11.6. Japan
11.7. Malaysia
11.8. Philippines
11.9. Singapore
11.10. South Korea
11.11. Taiwan
11.12. Thailand
11.13. Vietnam
12. Europe, Middle East & Africa Healthcare Fraud Detection Market
12.1. Introduction
12.2. Denmark
12.3. Egypt
12.4. Finland
12.5. France
12.6. Germany
12.7. Israel
12.8. Italy
12.9. Netherlands
12.10. Nigeria
12.11. Norway
12.12. Poland
12.13. Qatar
12.14. Russia
12.15. Saudi Arabia
12.16. South Africa
12.17. Spain
12.18. Sweden
12.19. Switzerland
12.20. Turkey
12.21. United Arab Emirates
12.22. United Kingdom
13. Competitive Landscape
13.1. FPNV Positioning Matrix
13.2. Market Share Analysis, By Key Player
13.3. Competitive Scenario Analysis, By Key Player
14. Competitive Portfolio
14.1. Key Company Profiles
14.1.1. CGI Inc.
14.1.2. Change Healthcare
14.1.3. Conduent Inc.
14.1.4. Cotiviti Inc.
14.1.5. DXC Technology Company
14.1.6. ExlService Holdings Inc.
14.1.7. Fair Isaac Corporation
14.1.8. FraudLens Inc.
14.1.9. H20.ai
14.1.10. HCL Technologies Limited
14.1.11. International Business Machines Corporation
14.1.12. Northrop Grumman Corporation
14.1.13. Optum Inc.
14.1.14. OSP Labs
14.1.15. SAS Institute Inc.
14.1.16. Wipro Ltd.
14.2. Key Product Portfolio
15. Appendix
15.1. Discussion Guide
15.2. License & Pricing
FIGURE 1. HEALTHCARE FRAUD DETECTION MARKET RESEARCH PROCESS
FIGURE 2. HEALTHCARE FRAUD DETECTION MARKET SIZE, 2023 VS 2030
FIGURE 3. HEALTHCARE FRAUD DETECTION MARKET SIZE, 2018-2030 (USD MILLION)
FIGURE 4. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY REGION, 2023 VS 2030 (%)
FIGURE 5. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY REGION, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 6. HEALTHCARE FRAUD DETECTION MARKET DYNAMICS
FIGURE 7. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY SOLUTION TYPE, 2023 VS 2030 (%)
FIGURE 8. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY SOLUTION TYPE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 9. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY DELIVERY MODE, 2023 VS 2030 (%)
FIGURE 10. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY DELIVERY MODE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 11. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY APPLICATION, 2023 VS 2030 (%)
FIGURE 12. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY APPLICATION, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 13. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY END USER, 2023 VS 2030 (%)
FIGURE 14. HEALTHCARE FRAUD DETECTION MARKET SIZE, BY END USER, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 15. AMERICAS HEALTHCARE FRAUD DETECTION MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 16. AMERICAS HEALTHCARE FRAUD DETECTION MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 17. UNITED STATES HEALTHCARE FRAUD DETECTION MARKET SIZE, BY STATE, 2023 VS 2030 (%)
FIGURE 18. UNITED STATES HEALTHCARE FRAUD DETECTION MARKET SIZE, BY STATE, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 19. ASIA-PACIFIC HEALTHCARE FRAUD DETECTION MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 20. ASIA-PACIFIC HEALTHCARE FRAUD DETECTION MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 21. EUROPE, MIDDLE EAST & AFRICA HEALTHCARE FRAUD DETECTION MARKET SIZE, BY COUNTRY, 2023 VS 2030 (%)
FIGURE 22. EUROPE, MIDDLE EAST & AFRICA HEALTHCARE FRAUD DETECTION MARKET SIZE, BY COUNTRY, 2023 VS 2024 VS 2030 (USD MILLION)
FIGURE 23. HEALTHCARE FRAUD DETECTION MARKET, FPNV POSITIONING MATRIX, 2023
FIGURE 24. HEALTHCARE FRAUD DETECTION MARKET SHARE, BY KEY PLAYER, 2023

Pricing

Currency Rates
How Do Licenses Work?

How Do Licenses Work?

The primary function of a report license is to define how many people within a company are authorized to use the purchased report. This is separate to how a report might be delivered. Unless specifically identified otherwise, the purchase option is Single User. Below is a helpful description of that license, along with a sampling of others most commonly offered.

  • This license allows only one user to have access to and to use/read the report. It is not one user at a time or one user group; it is an individual who will be reading and utilizing the report.

  • This license allows for the entire purchasing company to read and use the report. This is the license level that would allow for a report to be placed on an internal company shared drive for access by all employees of that direct company. This license does not extend to parent or sister company use.

  • This license is designed to allow an entire department within a company full access to a report. The departmental license is a great option for companies that have more than one location and the department is spread out all over the country/world

  • This license is for companies that have one location where they want the report to be accessible by all employees within that physical location.

  • This is the most flexible of the licensing options. Some publishers will allow you to get a license for a preset number of people (typically 5). These licenses are ideal for small work groups.

License options are at the discretion of each publisher. As such, not all licenses indicated above are available for every product. If you are uncertain of the best license for your needs or would like a license that is not proactively available, please contact us and we will be happy to assist.

Head shot

Questions or Comments?

Our team has the ability to search within reports to verify it suits your needs. We can also help maximize your budget by finding sections of reports you can purchase.
Chat Now
Contact Us