Global Healthcare Fraud Detection Market Size To Worth USD 16.61 Billion By 2033 | CAGR of 22.13%
Category: HealthcareGlobal Healthcare Fraud Detection Market Size To Worth USD 16.61 Billion By 2033
According to a research report published by Spherical Insights & Consulting, the Global Healthcare Fraud Detection Market Size is to Grow from USD 2.25 Billion in 2023 to USD 16.61 Billion by 2033, at a Compound Annual Growth Rate (CAGR) of 22.13% during the projected period.
Get more details on this report -
Browse key industry insights spread across 244 pages with 110 Market data tables and figures & charts from the report on the "Global Healthcare Fraud Detection Market Size, Share, and COVID-19 Impact Analysis, By Type (Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics), By Delivery Model (On-premises, Cloud-based, and Others), By Application (Insurance Claims Review, Pharmacy Billing Issues, Payment Integrity, and Others), By End User (Private Insurance Payers, Public and Government Agencies, Third Party Service Providers, and Others), and By Region (North America, Europe, Asia-Pacific, Latin America, Middle East, and Africa), Analysis and Forecast 2023 - 2033." Get Detailed Report Description Here: https://www.sphericalinsights.com/reports/healthcare-fraud-detection-market
Healthcare fraud detection works to detect and prevent healthcare fraud, waste, and abuse at every stage of the claim procedure. To facilitate efficient data management, it interfaces with the payment integrity solutions that are currently in use and collects data from internal and external sources, such as watch lists, unstructured texts, third parties, and claims systems. It is dependent upon several state-of-the-art analytical and artificial intelligence (AI) techniques, including text analytics algorithms, deep learning, machine learning (ML), and contemporary statistics. The number of patients seeking health insurance is increasing, which is driving up the need for healthcare fraud detection systems. This is one of the key elements propelling the market, together with the expanding prepayment review model in the healthcare sector. Furthermore, the sheer volume and unpredictable nature of healthcare data provide challenges for data interoperability, quality, and integration, which lower the effectiveness of analytics and algorithms for fraud detection.
The descriptive analytics segment is anticipated to hold the largest share of the global healthcare fraud detection market during the projected timeframe.
Based on the type, the global healthcare fraud detection market is divided into descriptive analytics, predictive analytics, and prescriptive analytics. Among these, the descriptive analytics segment is anticipated to hold the largest share of the global healthcare fraud detection market during the projected timeframe. This is because descriptive analytics systems are easy to use and can be easily integrated with other information sources to produce insightful analysis. Descriptive analytics is being used to assess a growing number of clinical decisions and their impact on overall patient outcomes, care quality, and service performance.
The on-premises segment is predicted to grow at the highest revenue share in the global healthcare fraud detection market during the projected timeframe.
Based on the delivery model, the global healthcare fraud detection market is divided into on-premises, cloud-based, and others. Among these, the on-premises segment is predicted to grow at the highest revenue share in the global healthcare fraud detection market during the projected timeframe. The site's data is freely accessible to hospitals and other organizations, which has enhanced data monitoring and record-keeping among other benefits. Small business systems are helpful, but as they get larger, managing a large dataset can become difficult and time-consuming.
The insurance claims review segment is predicted to grow at the largest pace in the global healthcare fraud detection market during the estimated period.
Based on the applications, the global healthcare fraud detection market is divided into insurance claims review, pharmacy billing issues, payment integrity, and others. Among these, the insurance claims review segment is predicted to grow at the largest pace in the global healthcare fraud detection market during the estimated period. Because more people purchase health insurance, there are more bogus claims, which is a direct result of this. The remaining component is divided into two parts: prepayment review and post-payment review.
The public and government agencies segment is predicted to grow at the fastest CAGR in the global healthcare fraud detection market during the estimated period.
Based on the end user, the global healthcare fraud detection market is divided into private insurance payers, public and government agencies, third party service providers, and others. Among these, the public and government agencies segment is predicted to grow at the fastest CAGR in the global healthcare fraud detection market during the estimated period. The primary reasons for the high percentage are the growing patient volume in government hospitals and the government institution's higher susceptibility to fraud due to a deficiency of highly developed technological infrastructure, especially in developing nations.
North America is expected to hold the largest share of the global healthcare fraud detection market over the forecast period.
Get more details on this report -
North America is expected to hold the largest share of the global healthcare fraud detection market over the forecast period. The market for fraud detection is defined by strong regulatory frameworks and an increasing number of cutting-edge healthcare systems. Legislative restrictions like the False Claims Act and the Affordable Care Act have led to a significant adoption of fraud detection systems in the region.
Europe is predicted to grow at the fastest pace in the global healthcare fraud detection during the projected timeframe. In the same way, as chronic illnesses become more common, insurance coverage for patient maintenance during hospitalization is expanding. For instance, chronic illnesses affect about 50 million individuals in Europe.
Major vendors in the global healthcare fraud detection market include IBM Corporation, Wipro Limited, HCL Technologies, Exlservice Holdings Inc., LexisNexis, Verscend Technologies, Mckesson, Conduent, Cotiviti Inc., OSP Labs, SAS Institute Inc., International Business Machines Corporation, Scioinspire CORP, FAIR ISAAC Corporation and Others.
Recent Developments
- In May 2023, the announcement was established by Teradata and FICO on the launch of integrated advanced analytical solutions aimed at real-time payment fraud, insurance claims, and supply chain optimization. The effective development of solutions to address diverse use cases in industries such as banking, healthcare, retail, manufacturing, and travel is made possible by the integration of data, analytics, and insights within a unified framework.
Key Target Audience
- Market Players
- Investors
- End-users
- Government Authorities
- Consulting And Research Firm
- Venture capitalists
- Value-Added Resellers (VARs)
Market Segment
This study forecasts revenue at global, regional, and country levels from 2020 to 2033. Spherical Insights has segmented the global healthcare fraud detection market based on the below-mentioned segments:
Global Healthcare Fraud Detection Market, By Type
- Descriptive Analytics
- Predictive Analytics
- Prescriptive Analytics
Global Healthcare Fraud Detection Market, By Delivery Model
- On-Premises
- Cloud-Based
- Others
Global Healthcare Fraud Detection Market, By Application
- Insurance Claims Review
- Pharmacy Billing Issues
- Payment Integrity
- Others
Global Healthcare Fraud Detection Market, By End User
- Private Insurance Payers
- Public And Government Agencies
- Third Party Service Providers
- Others
Global Healthcare Fraud Detection Market, By Regional
- North America
- US
- Canada
- Mexico
- Europe
- Germany
- UK
- France
- Italy
- Spain
- Russia
- Rest of Europe
- Asia Pacific
- China
- Japan
- India
- South Korea
- Australia
- Rest of Asia Pacific
- South America
- Brazil
- Argentina
- Rest of South America
- Middle East & Africa
- UAE
- Saudi Arabia
- Qatar
- South Africa
- Rest of the Middle East & Africa
About the Spherical Insights & Consulting
Spherical Insights & Consulting is a market research and consulting firm which provides actionable market research study, quantitative forecasting and trends analysis provides forward-looking insight especially designed for decision makers and aids ROI.
Which is catering to different industry such as financial sectors, industrial sectors, government organizations, universities, non-profits and corporations. The company's mission is to work with businesses to achieve business objectives and maintain strategic improvements.
CONTACT US:
For More Information on Your Target Market, Please Contact Us Below:
Phone: +1 303 800 4326 (the U.S.)
Phone: +91 90289 24100 (APAC)
Email: inquiry@sphericalinsights.com, sales@sphericalinsights.com
Contact Us: https://www.sphericalinsights.com/contact-us
Need help to buy this report?