Healthcare Fraud Detection Market – Overview
The escalated expenses related to healthcare services in increasing the frequency of fraud in the healthcare
sector. Market reports connected with the healthcare IT industry have been presented by Market Research
Future which makes reports on other industry verticals that aims to analyze the current market scenarios
better. The market is anticipated to attain returns worth USD 639.07 million while expanding at a CAGR of
26.7% in the forecast period.
The detection of healthcare fraud has gained increased momentum due to the development of stringent and
thorough checks in the procedure for claims. Moreover, the emphasis on reducing losses to the insurance
companies is expected to fuel the development of the healthcare fraud detection market in the coming years.
The need to detect linkages among seemingly unrelated claims is expected to be one of the key areas for the
progress of the market.
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Competitive Analysis:
Significant reductions in administrative costs are inducing further expansion of the market. The vertical
additions and product tactics of the market are boosting the potential of the market players. The
development of a robust value chain is further motivating the development of the market. The strategic goals
intended for the market are reinforced due to favorable product differentiation carried out by market
competitors. The growth of the market is moving in a favorable direction due to new product launches or
rising gross revenue of the players in the market. Increased adaptability of market players to new market
trends and customers inclinations are lifting the growth curve of the market and will continue do so in the
forecast period. The successful implementation of strategies is expected to motivate the market in the
coming years.
The major contenders in the market are Optum, Verscend Technologies, McKesson, Fair Isaac, SAS Institute,
HCL Technologies, Conduent, Wipro, LexisNexis, International Business Machines Corporation (IBM), Scio
Health Analytics, CGI Group, DXC Technology, Northrop Grumman, and Pondera Solutions
Segmental Analysis:
The segmental analysis of the healthcare fraud detection market is carried out on the basis of end user,
component, application, delivery model, type, and region. On the basis of component, the market has been
segmented into services and software. Based on delivery model, the market has been segmented into on-
demand delivery and on-premise delivery models. The segmentation on the basis of type comprises of
predictive analytics, descriptive analytics, and prescriptive analytics. The descriptive segment is anticipated
to direct the market on the basis of type as descriptive analytics is the base for effective application of
prescriptive or predictive analytics. Based on application, the healthcare fraud detection market has been
segmented into payment integrity and insurance claims review. The insurance claims review segment has
been segmented into prepayment review and post-payment review. The end user basis of segmentation of