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Healthcare Fraud Detection - Global Strategic Business Report

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    Report

  • 475 Pages
  • November 2024
  • Region: Global
  • Global Industry Analysts, Inc
  • ID: 5991243
The global market for Healthcare Fraud Detection was estimated at US$1.6 Billion in 2023, and is projected to reach US$3.7 Billion by 2030, growing at a CAGR of 12.8% from 2023 to 2030. This comprehensive report provides an in-depth analysis of market trends, drivers, and forecasts, helping you make informed business decisions.

The growth in the healthcare fraud detection market is driven by several factors. The increasing volume of healthcare data and the complexity of fraud schemes necessitate advanced solutions for effective detection. Rising healthcare costs and stringent regulatory requirements are compelling healthcare organizations to invest in robust fraud detection systems. Technological advancements, such as AI, ML, blockchain, and NLP, are expanding the capabilities of these systems, making them more effective and accessible. The increasing adoption of electronic health records (EHRs) and digital payment systems is also driving demand for sophisticated fraud detection tools. Furthermore, the global push towards digital transformation in healthcare, accelerated by the COVID-19 pandemic, has highlighted the need for enhanced cybersecurity measures, including fraud detection. As these trends continue to evolve, the healthcare fraud detection market is poised for sustained growth, driven by the need to protect healthcare systems from financial losses and ensure the delivery of high-quality care.

Key Insights:

  • Market Growth: Understand the significant growth trajectory of the Services Component segment, which is expected to reach US$2.2 Billion by 2030 with a CAGR of a 12.4%. The Software Component segment is also set to grow at 13.5% CAGR over the analysis period.
  • Regional Analysis: Gain insights into the U.S. market, estimated at $428.2 Million in 2023, and China, forecasted to grow at an impressive 17.1% CAGR to reach $798.1 Million by 2030. Discover growth trends in other key regions, including Japan, Canada, Germany, and the Asia-Pacific.

Why You Should Buy This Report:

  • Detailed Market Analysis: Access a thorough analysis of the Global Healthcare Fraud Detection Market, covering all major geographic regions and market segments.
  • Competitive Insights: Get an overview of the competitive landscape, including the market presence of major players across different geographies.
  • Future Trends and Drivers: Understand the key trends and drivers shaping the future of the Global Healthcare Fraud Detection Market.
  • Actionable Insights: Benefit from actionable insights that can help you identify new revenue opportunities and make strategic business decisions.

Key Questions Answered:

  • How is the Global Healthcare Fraud Detection Market expected to evolve by 2030?
  • What are the main drivers and restraints affecting the market?
  • Which market segments will grow the most over the forecast period?
  • How will market shares for different regions and segments change by 2030?
  • Who are the leading players in the market, and what are their prospects?

Report Features:

  • Comprehensive Market Data: Independent analysis of annual sales and market forecasts in US$ Million from 2023 to 2030.
  • In-Depth Regional Analysis: Detailed insights into key markets, including the U.S., China, Japan, Canada, Europe, Asia-Pacific, Latin America, Middle East, and Africa.
  • Company Profiles: Coverage of major players such as CGI, Inc., Cotiviti, Inc., DXC Technology Company, and more.
  • Complimentary Updates: Receive free report updates for one year to keep you informed of the latest market developments.

Select Competitors (Total 86 Featured):

  • CGI, Inc.
  • Cotiviti, Inc.
  • DXC Technology Company
  • Exlservice Holdings, Inc.
  • Fair Isaac Corporation
  • H2O.ai
  • IBM Corporation
  • LexisNexis Risk Solutions Group
  • McKesson Corporation
  • Novigo Solutions
  • OSP LABS
  • Rosella Software
  • SAS Institute, Inc.
  • United Healthcare Group
  • Wipro Ltd.;

Table of Contents

I. METHODOLOGYII. EXECUTIVE SUMMARY
1. MARKET OVERVIEW
  • Influencer Market Insights
  • Global Economic Update
  • Healthcare Fraud Detection - Global Key Competitors Percentage Market Share in 2024 (E)
  • Competitive Market Presence - Strong/Active/Niche/Trivial for Players Worldwide in 2024 (E)
2. FOCUS ON SELECT PLAYERS
3. MARKET TRENDS & DRIVERS
  • Increasing Volume of Healthcare Data Propels Demand for Advanced Detection Solutions
  • Technological Advancements in AI and ML Strengthen Business Case for Fraud Detection Systems
  • Adoption of Blockchain Technology Expands Addressable Market Opportunity
  • Rising Healthcare Costs Spur Investment in Fraud Detection Systems
  • Stringent Regulatory Requirements Generate Demand for Robust Fraud Prevention Measures
  • Integration of Natural Language Processing Enhances Detection Capabilities
  • Growing Complexity of Fraud Schemes Throws Spotlight on Need for Advanced Solutions
  • Predictive Analytics Drives Proactive Fraud Prevention Strategies
  • Increasing Adoption of Electronic Health Records (EHRs) Accelerates Market Growth
  • Digital Payment Systems Propel Demand for Sophisticated Fraud Detection Tools
  • Expansion of Telehealth Services Generates New Challenges and Opportunities for Fraud Detection
  • Focus on Reducing False Positives Sustains Growth in Fraud Detection Technologies
  • Increasing Awareness of Financial Losses Due to Fraud Drives Adoption of Detection Systems
  • Enhanced Data Privacy Regulations Generate Demand for Secure Fraud Detection Technologies
  • Emergence of Real-Time Detection Solutions Strengthens Market Position
4. GLOBAL MARKET PERSPECTIVE
  • Table 1: World Healthcare Fraud Detection Market Analysis of Annual Sales in US$ Thousand for Years 2014 through 2030
  • Table 2: World Recent Past, Current & Future Analysis for Healthcare Fraud Detection by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 3: World Historic Review for Healthcare Fraud Detection by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 4: World 16-Year Perspective for Healthcare Fraud Detection by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets for Years 2014, 2024 & 2030
  • Table 5: World Recent Past, Current & Future Analysis for Services Component by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 6: World Historic Review for Services Component by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 7: World 16-Year Perspective for Services Component by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 8: World Recent Past, Current & Future Analysis for Software Component by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 9: World Historic Review for Software Component by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 10: World 16-Year Perspective for Software Component by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 11: World Recent Past, Current & Future Analysis for Other End-Uses by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 12: World Historic Review for Other End-Uses by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 13: World 16-Year Perspective for Other End-Uses by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 14: World Recent Past, Current & Future Analysis for Healthcare Payer End-Use by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 15: World Historic Review for Healthcare Payer End-Use by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 16: World 16-Year Perspective for Healthcare Payer End-Use by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 17: World Recent Past, Current & Future Analysis for Government Agencies End-Use by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 18: World Historic Review for Government Agencies End-Use by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 19: World 16-Year Perspective for Government Agencies End-Use by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 20: World Recent Past, Current & Future Analysis for Descriptive Analytics by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 21: World Historic Review for Descriptive Analytics by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 22: World 16-Year Perspective for Descriptive Analytics by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 23: World Recent Past, Current & Future Analysis for Prescriptive Analysis by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 24: World Historic Review for Prescriptive Analysis by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 25: World 16-Year Perspective for Prescriptive Analysis by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 26: World Recent Past, Current & Future Analysis for Predictive Analytics by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 27: World Historic Review for Predictive Analytics by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 28: World 16-Year Perspective for Predictive Analytics by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 29: World Recent Past, Current & Future Analysis for Insurance Claims Application by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 30: World Historic Review for Insurance Claims Application by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 31: World 16-Year Perspective for Insurance Claims Application by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
  • Table 32: World Recent Past, Current & Future Analysis for Payment Integrity Application by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2023 through 2030 and % CAGR
  • Table 33: World Historic Review for Payment Integrity Application by Geographic Region - USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa Markets - Independent Analysis of Annual Sales in US$ Thousand for Years 2014 through 2022 and % CAGR
  • Table 34: World 16-Year Perspective for Payment Integrity Application by Geographic Region - Percentage Breakdown of Value Sales for USA, Canada, Japan, China, Europe, Asia-Pacific, Latin America, Middle East and Africa for Years 2014, 2024 & 2030
III. MARKET ANALYSIS
UNITED STATES
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in the United States for 2024 (E)
CANADA
JAPAN
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Japan for 2024 (E)
CHINA
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in China for 2024 (E)
EUROPE
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Europe for 2024 (E)
FRANCE
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in France for 2024 (E)
GERMANY
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Germany for 2024 (E)
ITALY
UNITED KINGDOM
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in the United Kingdom for 2024 (E)
SPAINRUSSIAREST OF EUROPE
ASIA-PACIFIC
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Asia-Pacific for 2024 (E)
AUSTRALIA
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Australia for 2024 (E)
INDIA
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in India for 2024 (E)
SOUTH KOREAREST OF ASIA-PACIFIC
LATIN AMERICA
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Latin America for 2024 (E)
ARGENTINABRAZILMEXICOREST OF LATIN AMERICA
MIDDLE EAST
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Middle East for 2024 (E)
IRANISRAELSAUDI ARABIAUNITED ARAB EMIRATESREST OF MIDDLE EAST
AFRICA
  • Healthcare Fraud Detection Market Presence - Strong/Active/Niche/Trivial - Key Competitors in Africa for 2024 (E)
IV. COMPETITION

Companies Mentioned (Partial List)

A selection of companies mentioned in this report includes, but is not limited to:

  • CGI, Inc.
  • Cotiviti, Inc.
  • DXC Technology Company
  • Exlservice Holdings, Inc.
  • Fair Isaac Corporation
  • H2O.ai
  • IBM Corporation
  • LexisNexis Risk Solutions Group
  • McKesson Corporation
  • Novigo Solutions
  • OSP LABS
  • Rosella Software
  • SAS Institute, Inc.
  • United Healthcare Group
  • Wipro Ltd.;

Table Information