Industry Trends, Growth and Analysis For Healthcare Fraud Analytics

Nilkanth Rathod

Industry Trends, Growth and Analysis For Healthcare Fraud Analytics

Fraud analytics is the efficient use of data analytics and related business insights developed through statistical, quantitative, predictive, comparative, cognitive, and other emerging applied analytical models for detecting and preventing healthcare fraud.

The global healthcare fraud analytics market is projected to reach USD 5.0 billion by 2026 from USD 1.5 billion in 2021, at a CAGR of 26.7% during the forecast period. Market growth can be attributed to a large number of fraudulent activities in healthcare, the increasing number of patients seeking health insurance, high returns on investment, and the rising number of pharmacy claims-related frauds. However, the dearth of skilled personnel is expected to restrain the growth of this market.

The global healthcare fraud analytics market is facing a plethora of challenges. Travel bans and quarantines, halt of indoor/outdoor activities, temporary shutdown of business operations, supply-demand fluctuations, stock market volatility, falling business assurance, and many uncertainties are somehow exerting a partial negative impact on the business dynamics.

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The healthcare industry has been witnessing a number of cases of fraud, done by patients, doctors, physicians, and other medical specialists. Many healthcare providers and specialists have been observed to be engaged in fraudulent activities, for the sake of profit. In the healthcare sector, fraudulent activities done by patients include the fraudulent procurement of sickness certificates, prescription fraud, and evasion of medical charges.

A couple of reasons contributing to the growth of the health insurance market include the rise in the aging population, growth in healthcare expenditure, and increased burden of diseases. In the US, the number of citizens without health insurance has significantly decreased, from 48 million in 2010 to 28.6 million in 2016. In 2017, 12.2 million people signed up for or renewed their health insurance during the 2017 open enrollment period (Source: National Center for Health Statistics).

This growth is aided by the increasing affordability of health insurance for the middle class in this region and the rising awareness regarding the benefits of health insurance. In the UAE, as per a new regulatory policy (2017), any citizen residing and working in the UAE needs to be insured medically.

Major players in this market include IBM Corporation (US), Optum, Inc. (US), Cotiviti, Inc. (US), Change Healthcare (US), Fair Isaac Corporation (US), SAS Institute Inc. (US), EXLService Holdings, Inc. (US), Wipro Limited (India), Conduent, Incorporated (US), CGI Inc. (Canada), HCL Technologies Limited (India), Qlarant, Inc. (US), DXC Technology (US), Northrop Grumman Corporation (US), LexisNexis (US), Healthcare Fraud Shield (US), Sharecare, Inc. (US), FraudLens, Inc. (US), HMS Holding Corp. (US), Codoxo (US), H20.ai (US), Pondera Solutions, Inc. (US), FRISS (The Netherlands), Multiplan (US), FraudScope (US), and OSP Labs (US).

Research Developments Analysis

In January 2019, LexisNexis Risk Solutions collaborated with QuadraMed to enable patient identification capabilities and reduce the number of duplicate identities & fraudulent claims.
In August 2018, Verscend Technologies acquired Cotiviti Holdings. This acquisition helped improve the affordability of fraud detection solutions.
In June 2018, SAS Institute & Prime Therapeutics LLC teamed up, enabling Prime Therapeutics to utilize SAS’s analytic capabilities to combat the opioid crisis in the US

Nilkanth Rathod

Healthcare Fraud Analytics Market Size, Scope, Growth, and Competitive Analysis

Nilkanth Rathod 2022-03-16

A large number of fraudulent activities in healthcare, increasing number of patients seeking health insurance, high returns on investment, and the rising number of pharmacy claims-related frauds. However, the dearth of skilled personnel is expected to restrain the growth of this market. Many healthcare providers and specialists have been observed to be engaged in fraudulent activities, for the sake of profit. In the healthcare sector, fraudulent activities done by patients include the fraudulent procurement of sickness certificates, prescription fraud, and evasion of medical charges. id=221837663 Fraud analytics is the efficient use of data analytics and related business insights developed through statistical, quantitative, predictive, comparative, cognitive, and other emerging applied analytical models for detecting and preventing healthcare fraud.

The Future of Healthcare Fraud Analytics Market - Trends And Growth

Healthcare Research Reports 2022-01-20

However, the dearth of skilled personnel is expected to restrain the growth of this market. id=221837663 The healthcare industry has been witnessing a number of cases of frauds, done by patients, doctors, physicians, and other medical specialists. Many healthcare providers and specialists have been observed to be engaged in fraudulent activities, for the sake of profit. In the healthcare sector, fraudulent activities done by patients include the fraudulent procurement of sickness certificates, prescription fraud, and evasion of medical charges. A couple of reasons contributing to the growth of the health insurance market include the rise in the aging population, growth in healthcare expenditure, and increased burden of diseases.

Fraud Analytics Software Market Size, In-depth Analysis Report and Global Forecast to 2030

Monal Sharma 2023-12-30

COVID-19 Impact Analysis on Fraud Analytics Software Market report published by Value Market Research provides a detailed market analysis comprising market size, share, value, growth and trends for the period 2022-2030. Get more information on "Global Fraud Analytics Software Market Research Report" by requesting FREE Sample Copy at https://www. Additionally, these tools also give an inclusive assessment of each segment in the global market of fraud analytics software. Browse Global Fraud Analytics Software Market Research Report with detailed TOC at https://www. Purchase Complete Global Fraud Analytics Software Market Research Report at https://www.

Global Healthcare Fraud Analytics Market 2020: COVID-19 Impact Analysis and Industry Forecast Report, 2027

ChhayaTiwari 2021-11-29

COVID-19 Impact Analysis on Healthcare Fraud Analytics Market report published by Value Market Research provides a detailed market analysis comprising market size, share, value, growth and trends for the period 2020-2027. The major players in the healthcare fraud analytics market include Conduent Inc. Get more information on "Global Healthcare Fraud Analytics Market Research Report" by requesting FREE Sample Copy at https://www. Browse Global Healthcare Fraud Analytics Market Research Report with detailed TOC at https://www. Purchase Complete Global Healthcare Fraud Analytics Market Research Report at https://www.

Healthcare Fraud Analytics Market 2022 Size, Growth Factors & Forecast Report to 2028

Aric Alexander 2022-11-03

The new Healthcare Fraud Analytics Market report offers a comprehensive study of the current scenario of the market including major market dynamics. The major players in the healthcare fraud analytics market include Conduent Inc. Get more information on "Global Healthcare Fraud Analytics Market Research Report" by requesting FREE Sample Copy at https://www. Browse Global Healthcare Fraud Analytics Market Research Report with detailed TOC at https://www. By Component· Services· SoftwareBy Delivery Mode· On-Demand· On-PremiseBy Analytical Type· Predictive Analytics· Prescriptive Analytics· Descriptive AnalyticsBy Application· Insurance Claims Review· Pharmacy Billing Misuse· Payment Integrity· Identity & Case Management· OthersBy End User· Public & Government Agencies· Private Insurance Payers· Third-Party Service Providers· EmployersRegional AnalysisThis section covers the regional outlook, which accentuates current and future demand for the Healthcare Fraud Analytics market across North America, Europe, Asia-Pacific, Latin America, and Middle East & Africa.

Healthcare Fraud Analytics Market Forecasts by Global Industry Analysis Report

Lalta Daas 2023-07-07

Get more information on "Global Healthcare Fraud Analytics Market Research Report" by requesting FREE Sample Copy at https://www. Additionally, these tools also give an inclusive assessment of each segment in the global market of healthcare fraud analytics. The growth and trends of healthcare fraud analytics industry provide a holistic approach to this study. Browse Global Healthcare Fraud Analytics Market Research Report with detailed TOC at https://www. Purchase Complete Global Healthcare Fraud Analytics Market Research Report at https://www.

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The researchers, as well as doctors, can benefit from predictive analytics to see what can happen.

The more data you have, the more accurate and detailed result you will get (like a trend line or risk score.)

All these insights give a foundation for prescriptive analytics, which also calculates probabilities.

Precise Treatment & Personalized Healthcare - Make Better Decisions

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Online shopping site sells fraud makeup products and they attract the customer by giving the discount but the products are actually fake when you get to know when the medicine doesn't work and start showing harmful side-effects.

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Healthcare Fraud Analytics Market Size is Predicted to Witness 24.3% CAGR till 2030

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The global Healthcare Fraud Analytics Market size is expected to reach USD 11. The healthcare industry has observed various fraud cases on the part of doctors, patients, physicians, and other healthcare specialists. Initiatives like collaborations or partnerships with local players, acquisitions, or new product launches by market players contribute to the market growth. Related Press Release@ Healthcare Fraud Analytics Market ReportList of Key Players in the Healthcare Fraud Analytics MarketIBMOptum, Inc. EXL Service Holdings, IncWipro LimitedConduent, IncHCL Technologies LimitedOSP Labs Healthcare Fraud Analytics Market Report HighlightsIn terms of revenue, the descriptive analytics segment dominated the solution type segment with a share of around 40.

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Predictive analytics is a technology used in the field of business intelligence that produces predictive information for customers or organizations.

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