Global Healthcare Fraud Detection Market can attain a strong valuation of USD 18,300.31 Million by 2030 at 29.50%.
Healthcare Fraud Detection Market Overview
Market Research Future (MRFR) evaluates that the Global Healthcare Fraud Detection Market can attain a strong valuation of USD 18,300.31 Million by 2030.
Following the COVID-19 outbreak, healthcare IT has been at the epicentre of a host of challenges posed by the pandemic worldwide. Virtual care and data technologies along with healthcare IT systems such as digitalization, analytical technologies and more have backed the healthcare IT market during the novel coronavirus outbreak. Healthcare fraud detection solutions have been observing a higher demand since the lockdown, given the rising need for solutions that have biometric sensors to identify frauds. The alarming surge in unauthorized payments and other threats following the SARS-CoV-2 pandemic has also bolstered the demand for healthcare fraud detection services and solutions.
Expanding Patient Pool Opting for Healthcare Insurance to Benefit the Market
Burgeoning patient pool opting for health care insurance, alarming rise in fraudulent events in the healthcare industry, and the rising pressure to track abuse and fraud in healthcare are some of the top growth boosters in the global market.
A few other encouraging factors include the growing number of healthcare BPO, introduction of cutting edge fraud identity management software, rising adoption of cloud-based analytical solutions and social media’s significant influence on the healthcare industry. The surging integration of artificial intelligence (AI) in healthcare solutions and services could also work in the favor of the global healthcare fraud detection market.
Developing Countries to Provide Attractive Opportunities
Supportive initiatives taken up by governments to bolster the healthcare IT industry could be an attractive opportunity for healthcare fraud detection firms in the coming years. The surge in funding for the implementation of several IT platforms in the healthcare industry will create a host of growth avenues for the leading vendors during the evaluation period.
Low Awareness Level in Emerging Countries to be a Restraint
Lower awareness level regarding healthcare fraud analytics solutions in emerging countries is expected to restrain the market growth in the near future.
Reluctance among Companies to Challenge Market Growth
Dearth of skilled professionals to deal with the healthcare fraud detection technology, and the companies unwilling to adopt new technologies could be key challenges surrounding the global industry.
Cumulative Growth Analysis
Market Share Set to Thrive at a Strong Rate
MRFR believes that the Healthcare Fraud Detection Market can soar at a significant rate of 28.83% during the forecast period from 2019 to 2024, in view of the surge in fraudulent events within the healthcare industry and the expanding pool of patients taking up healthcare insurance.
Descriptive Analytics Type Captures the Highest Share
Various types of healthcare fraud detection solutions in the market are predictive analytics, prescriptive analytics and descriptive analytics. Between these, the descriptive analytics segment owns the biggest share in the global market as these types facilitate efficient application of prescriptive or predictive analytics.
Software Segment to be in the Lead
Key components covered in the report are software and services. The healthcare fraud detection software market is growing at a stable rate thanks to the emergence of technically advanced software and the resultant surge in their demand.
Insurance Claims Review Segment Seizes the Biggest Share
The main applications of healthcare fraud detection solutions are insurance claims review as well as payment integrity. In the lead is the insurance claims review segment, with the biggest share in the healthcare fraud analytics market due to the soaring number of people opting for health insurance, surge in fraudulent claims, and the escalating uptake of prepayment review model among patients.
Public/Government Agencies Segment to Secure the Lead
Public/government agencies, third-party service providers and private insurance payers are the key end-users listed in the report. Public/government agencies are expected to be the top market end-users in the coming years.
America to Emerge as the Most Lucrative Market
The Americas, 2018, took the lead with the biggest share of 49.97% in the global industry. Americas has emerged as a lucrative market, in view of the rising use of technically innovative products, supportive reimbursement policies, and the rising spending on healthcare analytical services. An expansive pool of world-renowned players that offer an extensive range of healthcare fraud detection solutions also bolsters the market share in the region.
Europe Secures the Second Position
Europe has landed the second spot in the medical fraud detection management system market, thanks to the surging adoption of cloud-based analytic solutions, social media’s rising influence on the healthcare sector, and the growing integration of artificial intelligence in various healthcare solutions and services.
APAC to Procure a Significant Growth Rate
The Asia Pacific healthcare fraud detection market size is expanding on the back of the soaring number of government anti-fraud initiatives, growing need to cut down healthcare costs, technological advances, and increasing service and product availability. Rising threats in the region, especially in India and China, has boosted the focus of major companies on developing advanced healthcare fraud prevention services, which helps foster market growth. Moreover, growing popularity of medical tourism and rising demand in the pharmaceutical industry can emerge as key healthcare fraud detection market trends in the region.
Competition Rises as Major Companies Focus on Technical Advances
Technological innovations and launch of new solutions and services are some of the major parameters leading to intense competition in the fraud in healthcare industry. Many of the companies are focused on bolstering their portfolio of medical fraud prevention solutions, while also adopting strategies like partnerships, acquisitions, and mergers to stay competitive.
Optum is a well-renowned brand in the healthcare fraud detection software market, with its Optum Program Integrity Solutions delivering insightful intelligence. The system helps generate information that assists end-users in preventing inappropriate payments, identify suspicious activity, and boost recoveries. The company has made a huge name in the healthcare fraud analytics market, offering advanced solutions that are designed primarily for Medicaid in the US.
Scope of the Report
Healthcare fraud detection software market, healthcare fraud detection market trends, healthcare fraud detection market size, healthcare and fraud solutions, healthcare fraud detection solutions, medical fraud detection management system market are some of the top parameters considered in the scope of the report. MRFR report extensively covers the global healthcare fraud detection market, with respect to type, component, delivery model, application and regions.
Global Healthcare Fraud Detection Market, By Component
Global Healthcare Fraud Detection Market, By Delivery Model
Global Healthcare Fraud Detection Market, By Application
Global Healthcare Fraud Detection Market, By End User
|Market Size||USD 18,300.31 Million|
|Forecast Units||Value (USD Million)|
|Report Coverage||Revenue Forecast, Competitive Landscape, Growth Factors, and Trends|
|Segments Covered||Type, Component, Delivery Model, Application, End User|
|Geographies Covered||North America, Europe, Asia-Pacific, and Rest of the World (RoW)|
|Key Vendors||DXC Technology Company, UNITEDHEALTH group, SAS Institute Inc., WIPRO LIMITED, EXLSERVICE Holdings Inc., International Business Machines Corporation (IBM), COTIVITI INC., McKesson Corporation, CGI INC, FAIR ISAAC Corporation and LEXISNEXIS|
|Key Market Opportunities||
|Key Market Drivers||
Healthcare Fraud Detection Market is predicted to touch USD 18,300.31 million by 2030.
Healthcare Fraud Detection Market is projected to grow at a 29.50% CAGR between 2020-2030.
Americas is projected to dominate in the Healthcare Fraud Detection Market.
It finds extensive applications in Payment Integrity and Insurance Claims Review.
Unwillingness of various end users to use Healthcare Fraud analytics systems may deter market growth.