+353-1-416-8900REST OF WORLD
+44-20-3973-8888REST OF WORLD
1-917-300-0470EAST COAST U.S
1-800-526-8630U.S. (TOLL FREE)

PRINTER FRIENDLY

US Healthcare Fraud Analytics Market to 2027 - Country Analysis and Forecasts by Solution; Mode of Delivery; Application; End User

  • ID: 5006355
  • Report
  • February 2020
  • Region: United States
  • 77 pages
  • The Insight Partners
UP TO OFF
until Sep 30th 2020
1 of 3

Enquire about COVID-19 updates for this product.

Enquire Now

FEATURED COMPANIES

  • Conduent Inc.
  • Cotiviti, Inc
  • DXC Technology
  • FICO
  • Lexisnexis Risk Solutions
  • Optum, Inc.
  • MORE

The US Healthcare Fraud Analytics Market is expected to reach US$ 3,483.12 Mn in 2027 from US$ 517.28 Mn in 2019. The market is estimated to grow with a CAGR of 27.4% from 2020-2027.

The growth of the healthcare fraud analytics market is primarily attributed to the increasing number of healthcare fraudulent cases in the US and growing health insurance industry in the US. However, concerns regarding healthcare fraud analytics may hinder the growth of the market during the forecast period. The hospital industry is growing at a faster pace in the US. Though the average hospital stay for a single person has been slightly decreased from 7 days to 5-6 days over the last couple of decades in the US, but, the total number of hospital admissions increased to 36.5 million in 2017. An increase in the elder population is a major reason for driving the hospital market in the US.

For instance, as per the National Health Care Anti-Fraud Association (NHCAA) estimated that every year, losses due to healthcare frauds are in the tens of billions of dollars. Some government and law enforcement agencies also estimated that healthcare frauds cost around 10% of the total annual health expenditure, which could be around US$ 300 billion. Thus, an increasing number of fraudulent healthcare cases is likely to demand healthcare fraud analytics solutions
In 2019, the predictive analytics segment held the largest market share of the healthcare fraud analytics market, by solution. This segment is also anticipated to dominate the market in 2027 owing to its analytics detection and identification patterns. Also, the segment is anticipated to witness growth at a significant rate during the forecast period, 2020 to 2027.

The US healthcare fraud analytics market by mode of delivery is segmented into on-premise delivery models, cloud-based delivery models. The US healthcare fraud analytics market is dominated by on-premise delivery models segment in 2019 with a considerable market share by mode of delivery. This segment is also predicted to dominate the market in 2027. However, cloud-based delivery models segment is anticipated to witness growth at a significant rate during the forecast period, 2020 to 2027, because it is an extremely manageable alternative which helps in the accessing real-time information.

In 2019, the insurance claims review held a largest market share of the healthcare fraud analytics market, by the application. This segment is also predicted to dominate the market in 2027 because it is very common and costly to the healthcare insurance system when fraud is detected and the number of health insurance frauds are increasing every year. Also, the insurance claims segment is anticipated to witness growth at a significant rate during the forecast period, 2020 to 2027.

In 2019, the government agencies segment held the largest market share of the healthcare fraud analytics market, by end user. This segment is also anticipated to dominate the market in 2027 as data analytics allows the government agencies to observe the billing patterns and then spot the unusual and suspicious cases. Also, the segment is anticipated to witness growth at a significant rate during the forecast period, 2020 to 2027.

Some of the major primary and secondary sources for healthcare fraud analytics included in the report are Medicare & Medicaid Services, World Health Organization, Health Maintenance Organization, U.S. Department of Justice, and others.

Reasons to Buy:

  • Save and reduce time carrying out entry-level research by identifying the growth, size, leading players and segments in the Healthcare fraud analytics market.
  • Highlights key business priorities in order to assist companies to realign their business strategies.
  • The key findings and recommendations highlight crucial progressive industry trends in the US Healthcare fraud analytics market, thereby allowing players across the value chain to develop effective long-term strategies.
  • Develop/modify business expansion plans by using substantial growth offering developed and emerging markets.
  • Scrutinize in-depth US market trends and outlook coupled with the factors driving the market, as well as those hindering it.
  • Enhance the decision-making process by understanding the strategies that underpin security interest with respect to client products, segmentation, pricing and distribution.
Note: Product cover images may vary from those shown
2 of 3

FEATURED COMPANIES

  • Conduent Inc.
  • Cotiviti, Inc
  • DXC Technology
  • FICO
  • Lexisnexis Risk Solutions
  • Optum, Inc.
  • MORE
1. Introduction
1.1 Scope of the Study
1.2 Report Guidance
1.3 Market Segmentation
1.3.1 US Healthcare Fraud Analytics Market - By Solution
1.3.2 US Healthcare Fraud Analytics Market - By Mode of Delivery
1.3.3 US Healthcare Fraud Analytics Market - By Application
1.3.4 US Healthcare Fraud Analytics Market - By End User

2. Healthcare Fraud Analytics Market - Key Takeaways

3. Research Methodology
3.1 Coverage
3.2 Secondary Research
3.3 Primary Research

4. Healthcare Fraud Analytics- Market Landscape
4.1 Overview
4.2 Pest Analysis
4.2.1 Healthcare Fraud Analytics Market in US: PEST Analysis
4.3 Expert Opinion

5. Healthcare Fraud Analytics Market - Key Dynamics
5.1 Drivers
5.1.1 Increasing Number of Healthcare Fraudulent Cases in the US
5.1.2 Growing Health Insurance Industry in the US
5.2 Restraints
5.2.1 Concerns Regarding Healthcare Fraud Analytics
5.3 Opportunities
5.3.1 Growing Hospital Industry
5.4 Future Trends
5.4.1 AI in Healthcare Fraud Detection
5.5 Impact Analysis

6. Healthcare Fraud Analytics Market - US Analysis
6.1 US Healthcare Fraud Analytics Market Revenue Forecast And Analysis
6.2 Positioning of Key Players
6.2.1 Fair, Isaac and Company (FICO)
6.2.2 Conduent Inc.

7. Healthcare Fraud Analytics Market Analysis and Forecast to 2027 - Solution
7.1 Overview
7.2 Healthcare Fraud Analytics Market, By Solution, 2019 & 2027 (%)
7.3 US Healthcare Fraud Analytics Market, Revenue and Forecast to 2027, By Solution (US$ Mn)
7.4 Predictive Analytics
7.4.1 Overview
7.4.2 Predictive Analytics Market Revenue and Forecast to 2027 (US$ Mn)
7.5 Descriptive Analytics
7.5.1 Overview
7.5.2 Descriptive Analytics Market Revenue and Forecast to 2027 (US$ Mn)
7.6 Prescriptive Analytics
7.6.1 Overview
7.6.2 Prescriptive Analytics Market Revenue and Forecast to 2027 (US$ Mn)

8. Healthcare Fraud Analytics Market Analysis and Forecast to 2027 - Mode of Delivery
8.1 Overview
8.2 Healthcare Fraud Analytics Market, By Mode of Delivery, 2019 & 2027 (%)
8.3 US Healthcare Fraud Analytics Market, Revenue and Forecast to 2027, By Mode Of Delivery (US$ Mn)
8.4 On-Premise Delivery Models
8.4.1 Overview
8.4.2 On-Premise Delivery Models Market Revenue and Forecast to 2027 (US$ Mn)
8.5 Cloud-Based Delivery Mode
8.5.1 Overview
8.5.2 Cloud-Based Delivery Mode Market Revenue and Forecast to 2027 (US$ Mn)

9. Healthcare Fraud Analytics Market Analysis and Forecast to 2027 -Application
9.1 Overview
9.2 Healthcare Fraud Analytics Market, By Application, 2019 & 2027 (%)
9.3 US Healthcare Fraud Analytics Market, Revenue and Forecast to 2027, By Application (US$ Mn)
9.4 Insurance Claims Review
9.4.1 Overview
9.4.2 Insurance Claims Review Market Revenue and Forecast to 2027 (US$ Mn)
9.5 Pharmacy Billing Misuse
9.5.1 Overview
9.5.2 Pharmacy Billing Misuse Market Revenue and Forecast to 2027 (US$ Mn)
9.6 Payment Integrity
9.6.1 Overview
9.6.2 Payment Integrity Market Revenue and Forecast to 2027 (US$ Mn)
9.7 Medical Identity Theft
9.7.1 Overview
9.7.2 Medical Identity Theft Market Revenue and Forecast to 2027 (US$ Mn)
9.8 Other Applications
9.8.1 Overview
9.8.2 Other Applications Market Revenue and Forecast to 2027 (US$ Mn)

10. Healthcare Fraud Analytics Market Analysis and Forecast to 2027 -End User
10.1 Overview
10.2 Healthcare Fraud Analytics Market, By End User, 2019 & 2027 (%)
10.3 US Healthcare Fraud Analytics Market, Revenue and Forecast to 2027, End User (US$ Mn)
10.4 Government Agencies
10.4.1 Overview
10.4.2 Government Agencies Review Market Revenue and Forecast to 2027 (US$ Mn)
10.5 Private Insurance Payers
10.5.1 Overview
10.5.2 Private Insurance Payers Market Revenue and Forecast to 2027 (US$ Mn)
10.6 Third-party Service Providers
10.6.1 Overview
10.6.2 Third-party Service Providers Market Revenue and Forecast to 2027 (US$ Mn)
10.7 Employers
10.7.1 Overview
10.7.2 Employers Market Revenue and Forecast to 2027 (US$ Mn)

11. Healthcare Fraud Analytics Market to 2027- Industry Landscape
11.1 Overview
11.2 Growth Strategies Done By The Companies In The Market, (%)
11.3 Organic Developments Done By The Companies In The Market
11.4 Inorganic Developments Done By The Companies In The Market

12. Healthcare Fraud Analytics Market - Key Company Profiles
12.1 Conduent, Inc.
12.1.1 Key Facts
12.1.2 Business Description
12.1.3 Products and Services
12.1.4 Financial Overview
12.1.5 SWOT Analysis
12.1.6 Key Developments
12.2 DXC Technology Company
12.2.1 Key Facts
12.2.2 Business Description
12.2.3 Products and Services
12.2.4 Financial Overview
12.2.5 SWOT Analysis
12.2.6 Key Developments
12.3 SCIOInspire, Corp. (EXL Service Holdings, Inc.)
12.3.1 Key Facts
12.3.2 Business Description
12.3.3 Products and Services
12.3.4 Financial Overview
12.3.5 SWOT Analysis
12.3.6 Key Developments
12.4 OPTUM, INC (UnitedHealth Group)
12.4.1 Key Facts
12.4.2 Business Description
12.4.3 Products and Services
12.4.4 Financial Overview
12.4.5 SWOT Analysis
12.4.6 Key Developments
12.5 SAS Institute
12.5.1 Key Facts
12.5.2 Business Description
12.5.3 Products and Services
12.5.4 Financial Overview
12.5.5 SWOT Analysis
12.5.6 Key Developments
12.6 Pondera Solutions
12.6.1 Key Facts
12.6.2 Business Description
12.6.3 Products and Services
12.6.4 Financial Overview
12.6.5 SWOT Analysis
12.6.6 Key Developments
12.7 LexisNexis Risk Solutions (RELX plc)
12.7.1 Key Facts
12.7.2 Business Description
12.7.3 Products and Services
12.7.4 Financial Overview
12.7.5 SWOT Analysis
12.7.6 Key Developments
12.8 Fair, Isaac and Company (FICO)
12.8.1 Key Facts
12.8.2 Business Description
12.8.3 Financial Overview
12.8.4 Product Portfolio
12.8.5 SWOT Analysis
12.8.6 Key Developments
12.9 Cotiviti, Inc. (Verscend Technologies, Inc.)
12.9.1 Key Facts
12.9.2 Business Description
12.9.3 Financial Overview
12.9.4 Product Portfolio
12.9.5 SWOT Analysis
12.9.6 Key Developments
12.10 WhiteHatAI
12.10.1 Key Facts
12.10.2 Business Description
12.10.3 Financial Overview
12.10.4 Product Portfolio
12.10.5 SWOT Analysis
12.10.6 Key Developments

13. Appendix
13.1 About the Publisher
13.2 Glossary Of Terms
Note: Product cover images may vary from those shown
3 of 3
  • Conduent Inc.
  • DXC Technology
  • Scioinspire, Corp.
  • FICO
  • Optum, Inc.
  • SAS Institute
  • Pondera Solutions
  • Lexisnexis Risk Solutions
  • Whitehatai
  • Cotiviti, Inc
Note: Product cover images may vary from those shown
Adroll
adroll