Healthcare Fraud Detection Market by Solution Type, Delivery Mode, Application, End User

Description

List of Tables

[190 Pages Report] 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.

Global Healthcare Fraud Detection Market

KEY MARKET STATISTICS
Base Year [2023]	USD 1.91 billion
Estimated Year [2024]	USD 2.22 billion
Forecast Year [2030]	USD 6.91 billion
CAGR (%)	20.17%

Healthcare Fraud Detection Market - IMG1

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?

Product Code: MRR-742BD517F5D1

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