Global Healthcare Fraud Detection Market 2025-2029

Healthcare Fraud Detection Market 2025-2029

The healthcare fraud detection market is forecasted to grow by USD 1092.1 mn during 2024-2029, accelerating at a CAGR of 11.8% during the forecast period. The report on the healthcare fraud detection market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.

The report offers an up-to-date analysis regarding the current market scenario, the latest trends and drivers, and the overall market environment. The market is driven by increased number of patients seeking health insurance, increasing cases of healthcare fraud, and rise in number of health care bpo and fraud identity management software.

The study was conducted using an objective combination of primary and secondary information including inputs from key participants in the industry. The report contains a comprehensive market size data, segment with regional analysis and vendor landscape in addition to an analysis of the key companies. Reports have historic and forecast data.

Technavio's healthcare fraud detection market is segmented as below:

By Type

  • Descriptive analytics
  • Predictive analytics
  • Prescriptive analytics
By End-user
  • Private insurance payers
  • Third-party administrators (TPAs)
  • Government agencies
  • Hospitals and healthcare providers
By Delivery Mode
  • Cloud-based
  • On-premises
By Geographical Landscape
  • North America
  • Asia
  • Europe
  • Rest of World (ROW)
This study identifies the emergence of social media and its impact on healthcare industry as one of the prime reasons driving the healthcare fraud detection market growth during the next few years. Also, increasing favorable government initiatives and increase in cloud-based solutions for fraud detection will lead to sizable demand in the market.

The report on the healthcare fraud detection market covers the following areas:
  • Healthcare Fraud Detection Market sizing
  • Healthcare Fraud Detection Market forecast
  • Healthcare Fraud Detection Market industry analysis
The robust vendor analysis is designed to help clients improve their market position, and in line with this, this report provides a detailed analysis of several leading healthcare fraud detection market vendors that include CGI Inc., Change Healthcare Inc., Codoxo, Conduent Inc., Cotiviti Inc., ExlService Holdings Inc., Fair Isaac Corp., FraudLens, H2O.ai Inc., HCL Technologies Ltd., Healthcare Fraud Shield, International Business Machines Corp., Optum Inc., OSP, Qlarant Quality Solutions Inc., SAS Institute Inc., Thomson Reuters Corp., and Wipro Ltd.. Also, the healthcare fraud detection market analysis report includes information on upcoming trends and challenges that will influence market growth. This is to help companies strategize and leverage all forthcoming growth opportunities.

The publisher presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive primary and secondary research. The market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.


  • Executive Summary
    • Market overview
      • Table Executive Summary - Data Table on Market Overview
      • Table Executive Summary - Data Table on Incremental Growth
  • Technavio Analysis
    • Analysis of price sensitivity, lifecycle, customer purchase basket, adoption rates, and purchase criteria
    • Criticality of inputs and Factors of differentiation
    • Factors of disruption
    • Impact of drivers and challenges
  • Market Landscape
    • Market ecosystem
      • Table Data Table on - Parent Market
    • Market characteristics
    • Value chain analysis
  • Market Sizing
    • Market definition
    • Market segment analysis
    • Market size 2024
    • Market outlook: Forecast for 2024-2029
      • Table Data Table on Global - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Global Market: Year-over-year growth 2024-2029 (%)
  • Historic Market Size
    • Global Healthcare Fraud Detection Market 2019 - 2023
      • Table Historic Market Size - Data Table on Global Healthcare Fraud Detection Market 2019 - 2023 ($ million)
    • Type segment analysis 2019 - 2023
    • End-user segment analysis 2019 - 2023
    • Delivery Mode segment analysis 2019 - 2023
    • Geography segment analysis 2019 - 2023
    • Country segment analysis 2019 - 2023
  • Qualitative Analysis
    • The AI impact on Global Healthcare Fraud Detection Market
  • Five Forces Analysis
    • Five forces summary
    • Bargaining power of buyers
    • Bargaining power of suppliers
    • Threat of new entrants
    • Threat of substitutes
    • Threat of rivalry
    • Market condition
  • Market Segmentation by Type
    • Market segments
      • Table Data Table on Type - Market share 2024-2029 (%)
    • Comparison by Type
      • Table Data Table on Comparison by Type
    • Descriptive analytics - Market size and forecast 2024-2029
      • Table Data Table on Descriptive analytics - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Descriptive analytics - Year-over-year growth 2024-2029 (%)
    • Predictive analytics - Market size and forecast 2024-2029
      • Table Data Table on Predictive analytics - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Predictive analytics - Year-over-year growth 2024-2029 (%)
    • Prescriptive analytics - Market size and forecast 2024-2029
      • Table Data Table on Prescriptive analytics - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Prescriptive analytics - Year-over-year growth 2024-2029 (%)
    • Market opportunity by Type
      • Table Data Table on Market opportunity by Type ($ million)
  • Market Segmentation by End-user
    • Market segments
      • Table Data Table on End-user - Market share 2024-2029 (%)
    • Comparison by End-user
      • Table Data Table on Comparison by End-user
    • Private insurance payers - Market size and forecast 2024-2029
      • Table Data Table on Private insurance payers - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Private insurance payers - Year-over-year growth 2024-2029 (%)
    • Third-party administrators (TPAs) - Market size and forecast 2024-2029
      • Table Data Table on Third-party administrators (TPAs) - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Third-party administrators (TPAs) - Year-over-year growth 2024-2029 (%)
    • Government agencies - Market size and forecast 2024-2029
      • Table Data Table on Government agencies - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Government agencies - Year-over-year growth 2024-2029 (%)
    • Hospitals and healthcare providers - Market size and forecast 2024-2029
      • Table Data Table on Hospitals and healthcare providers - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Hospitals and healthcare providers - Year-over-year growth 2024-2029 (%)
    • Market opportunity by End-user
      • Table Data Table on Market opportunity by End-user ($ million)
  • Market Segmentation by Delivery Mode
    • Market segments
      • Table Data Table on Delivery Mode - Market share 2024-2029 (%)
    • Comparison by Delivery Mode
      • Table Data Table on Comparison by Delivery Mode
    • Cloud-based - Market size and forecast 2024-2029
      • Table Data Table on Cloud-based - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Cloud-based - Year-over-year growth 2024-2029 (%)
    • On-premises - Market size and forecast 2024-2029
      • Table Data Table on On-premises - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on On-premises - Year-over-year growth 2024-2029 (%)
    • Market opportunity by Delivery Mode
      • Table Data Table on Market opportunity by Delivery Mode ($ million)
  • Customer Landscape
    • Customer landscape overview
  • Geographic Landscape
    • Geographic segmentation
      • Table Data Table on Market share by geography 2024-2029 (%)
    • Geographic comparison
      • Table Data Table on Geographic comparison
    • North America - Market size and forecast 2024-2029
      • Table Data Table on North America - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on North America - Year-over-year growth 2024-2029 (%)
    • Asia - Market size and forecast 2024-2029
      • Table Data Table on Asia - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Asia - Year-over-year growth 2024-2029 (%)
    • Europe - Market size and forecast 2024-2029
      • Table Data Table on Europe - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Europe - Year-over-year growth 2024-2029 (%)
    • Rest of World (ROW) - Market size and forecast 2024-2029
      • Table Data Table on Rest of World (ROW) - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Rest of World (ROW) - Year-over-year growth 2024-2029 (%)
    • US - Market size and forecast 2024-2029
      • Table Data Table on US - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on US - Year-over-year growth 2024-2029 (%)
    • Canada - Market size and forecast 2024-2029
      • Table Data Table on Canada - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Canada - Year-over-year growth 2024-2029 (%)
    • China - Market size and forecast 2024-2029
      • Table Data Table on China - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on China - Year-over-year growth 2024-2029 (%)
    • Mexico - Market size and forecast 2024-2029
      • Table Data Table on Mexico - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Mexico - Year-over-year growth 2024-2029 (%)
    • Germany - Market size and forecast 2024-2029
      • Table Data Table on Germany - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Germany - Year-over-year growth 2024-2029 (%)
    • India - Market size and forecast 2024-2029
      • Table Data Table on India - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on India - Year-over-year growth 2024-2029 (%)
    • UK - Market size and forecast 2024-2029
      • Table Data Table on UK - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on UK - Year-over-year growth 2024-2029 (%)
    • Brazil - Market size and forecast 2024-2029
      • Table Data Table on Brazil - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Brazil - Year-over-year growth 2024-2029 (%)
    • Japan - Market size and forecast 2024-2029
      • Table Data Table on Japan - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on Japan - Year-over-year growth 2024-2029 (%)
    • France - Market size and forecast 2024-2029
      • Table Data Table on France - Market size and forecast 2024-2029 ($ million)
      • Table Data Table on France - Year-over-year growth 2024-2029 (%)
    • Market opportunity by geography
      • Table Data Tables on Market opportunity by geography ($ million)
  • Drivers, Challenges, and Opportunity/Restraints
    • Market drivers
      • Increased number of patients seeking health insurance
      • Increasing cases of healthcare fraud
    • Market challenges
      • Time-consuming deployment and need for frequent upgrades
      • High cost of health care fraud detection software and services
    • Impact of drivers and challenges
    • Market opportunities/restraints
      • Emergence of social media and its impact on healthcare industry
      • Increasing favorable government initiatives
  • Competitive Landscape
    • Overview
    • Competitive Landscape
    • Landscape disruption
    • Industry risks
  • Competitive Analysis
    • Companies profiled
    • Company ranking index
    • Market positioning of companies
    • CGI Inc.
    • Change Healthcare Inc.
    • Conduent Inc.
    • Cotiviti Inc.
    • ExlService Holdings Inc.
    • Fair Isaac Corp.
    • H2O.ai Inc.
    • HCL Technologies Ltd.
    • Healthcare Fraud Shield
    • International Business Machines Corp.
    • Optum Inc.
    • Qlarant Quality Solutions Inc.
    • SAS Institute Inc.
    • Thomson Reuters Corp.
    • Wipro Ltd.
  • Appendix
    • Scope of the report
      • Market definition
      • Objectives
      • Notes and caveats
    • Inclusions and exclusions checklist
    • Currency conversion rates for US$
    • Research methodology
    • Data procurement
    • Data validation
    • Validation techniques employed for market sizing
    • Data synthesis
    • 360 degree market analysis
    • List of abbreviations

Download our eBook: How to Succeed Using Market Research

Learn how to effectively navigate the market research process to help guide your organization on the journey to success.

Download eBook
Cookie Settings