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Healthcare Fraud Analytics Global Market Report 2022

Healthcare Fraud Analytics Global Market Report 2022

  • September 2022
  • 175 pages
  • ID: 6318507
  • Format: PDF
  • The Business Research Company


Table of Contents

Major players in the healthcare fraud analytics market are International Business Machines Corporation (IBM), Optum, Inc., SAS Institute, Inc., Change Healthcare, EXL Service Holdings, Inc., Cotiviti, Wipro Limited, Conduent, Inc., Hindustan Computers Limited Technologies Limited, CGI Inc, DXC Technology Company, Northrop Grumman Corporation, LexisNexis Group, Pondera Solutions, WhiteHatAI, Healthcare Fraud Shield, FraudLens, FraudScope, HMS Holding Corp., Fair, Isaac and Company(FICO), Qlarant, Inc., Codoxo, H20.ai, and OSP Labs, Sharecare, Inc.

The global healthcare fraud analytics market is expected to grow from $1.94 billion in 2021 to $2.43 billion in 2022 at a compound annual growth rate (CAGR) of 25.44%. The healthcare fraud analytics market is expected to reach $6.33 billion in 2026 at a CAGR of 27.06 %.

The healthcare fraud analytics market consists of sales of healthcare fraud analytics solutions and related services by entities (organizations, sole traders, and partnerships) that refer to on-premise and on-demand analytical solutions that assist in identifying issues such as duplication/repetition of claims and errors in claim healthcare operations and applications.Healthcare fraud analytics aims to help healthcare companies to audit their accounts and find out fraudulent activities in various transactions.

It identifies frauds related to billings, claims, prepayment, post payments, and payment integrity.

The main type of solutions in healthcare fraud analytics are descriptive analytics, predictive analytics, prescriptive analytics.Descriptive analytics is a process of using current and historical data to identify trends and relationships.

Healthcare fraud analytic solutions are deployed on-premise and on-demand, and they are widely used for insurance claims review, postpayment review, prepayment review, pharmacy billing misuse, payment integrity, other applications. Healthcare fraud analytics are used by public & government agencies, private insurance payers, third-party service providers.

North America was the largest region in the healthcare fraud analytics market in 2021.North America is expected to be the fastest-growing region in the forecast period.

The regions covered in healthcare fraud analytics market report are Asia-Pacific, Western Europe, Eastern Europe, North America, South America, Middle East and Africa.

The healthcare fraud analytics market research report is one of a series of new reports that provides healthcare fraud analytics market statistics, including healthcare fraud analytics industry global market size, regional shares, competitors with a healthcare fraud analytics market share, detailed healthcare fraud analytics market segments, market trends and opportunities, and any further data you may need to thrive in the healthcare fraud analytics industry. This healthcare fraud analytics market research report delivers a complete perspective of everything you need, with an in-depth analysis of the current and future scenarios of the industry.

A large number of fraudulent activities in the healthcare sector contribute to the growth of the healthcare fraud analytics market.Medical providers, patients, and third parties who intentionally deceive the healthcare system into acquiring unlawful benefits can commit fraud based on deception or misrepresentation.

These fraud and abuse involve kickbacks, billing, billing for services not provided, medical testing, and other fraudulent activities.For instance, In January 2019, Johns Hopkins HealthCare LLC projected that around 60 billion dollars are lost annually due to health care abuse and fraud.

Thus, the increasing number of fraudulent activities in healthcare are contributing to the growth of the healthcare fraud market.

Adopting and developing new technologies is a key trend gaining popularity in the healthcare fraud analytics market.The major companies are focusing on launching statistical data analytical and artificial intelligence (AI)-driven product and services to strengthen their market position.

These fraud detection techniques perform various statistical operations, including data mining, regression analysis, machine learning, pattern recognition, supervised learning, unsupervised learning, and others.For instance, In December 2020, Codoxo, a US-based, AI-driven solution for healthcare, launched a healthcare integrity suite that gives health agencies unique insights and solutions for identifying risks and controlling costs in clinical care, network management, and payment integrity, provider education, and special investigative units.

The suite includes fraud, provider, insight, network, clinical, and payment scope in its application.

In June 2020, Sharecare, an Atlanta-based digital health company, acquired WhiteHatAI for an undisclosed amount.With this acquisition, Sharecare will integrate the WhiteHatAI, an AI-driven suite across portfolios that will help detect FWA before it occurs, improving healthcare organizations’ efficiency and effectiveness.

WhiteHatAI is a US-based healthcare AI company for healthcare payment integrity and fraud, waste, and abuse prevention.

The countries covered in the healthcare fraud analytics market report are Australia, Brazil, China, France, Germany, India, Indonesia, Japan, Russia, South Korea, UK, USA.

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