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

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.

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