$ 5 Billion Healthcare Fraud Analytics Markets – Global Forecast to 2026 – ResearchAndMarkets.com

0

DUBLIN – (COMMERCIAL THREAD) – The “healthcare fraud analysis market by type of solution (descriptive, predictive, prescriptive), application (insurance claim, payment integrity), delivery (on-site, cloud), end user (government, employers, payers), COVID- 19 Impact – Global Forecast to 2026 “report has been added to ResearchAndMarkets.com offer.

The global healthcare fraud analysis market is expected to reach $ 5.0 billion by 2026, up from $ 1.5 billion in 2021, at a CAGR of 26.7% during the period forecast.

The growth of the market can be attributed to a large number of fraudulent activities in the healthcare field, the increase in the number of patients seeking health insurance, high returns on investment and the growing number of fraud related to claims. pharmaceuticals. However, the shortage of qualified personnel is expected to hamper the growth of this market.

The on-demand segment is expected to grow at the highest CAGR during the forecast period.

Based on the delivery model, the healthcare fraud analysis market is segmented into on-premise and on-demand models. On-demand models include cloud-based and web-based models. The on-demand segment is expected to register the highest CAGR during the forecast period. Factors such as selfish on-demand analysis, lack of up-front capital investment for hardware, extreme capacity flexibility, and pay-as-you-go pricing model are driving demand for on-demand fraud detection solutions .

The segment of the prepayment review model is expected to experience the highest growth during the forecast period.

On the basis of applications, the healthcare fraud analysis market is segmented into examination of insurance claims, pharmacy billing abuse, payment integrity, and other applications. The Insurance Claims Review segment is further divided into Post-Payment Review and Advance Review with the latter expected to register the highest growth during the forecast period.

This is primarily because the use of prepayment review protocols and analytics can help organizations proactively prevent pre-payment fraud, allowing for swift action to be taken. Therefore, prepayment review solutions are expected to gain more attention in the coming years.

North America accounted for the largest share of the healthcare fraud analysis market.

North America accounted for the largest share of this market in 2020, mainly due to the high penetration of Medicare in the region, a high number of cases of healthcare fraud, d ‘Supportive government initiatives to combat healthcare fraud and greater availability of products and services in this region. . In addition, the majority of the major players in the healthcare fraud analysis market are headquartered in North America.

Premium previews

  • A large number of fraudulent activities in healthcare to drive the growth of the market

  • Descriptive analytics segment accounted for largest share of Asian healthcare fraud analytics market in 2020

  • United States to Record Strongest Revenue Growth in Forecast Period

  • North America will continue to dominate the market in 2026

  • Developed markets will register higher growth during the forecast period

Market dynamics

Conductors

  • Large number of fraudulent activities in the health sector

  • Increase in the number of patients requesting health insurance

  • Prepayment review template

  • High returns on investment

  • Increase in fraud related to pharmacy claims

Constraints

  • Limitations of the Data Capture Process in Medicaid Services

Opportunities

  • Adopting Fraud Analysis in Healthcare in Developing Countries

  • Emergence of social media and its impact on the healthcare industry

  • Role of AI in Detecting Fraud in Healthcare

Challenges

  • Shortage of qualified personnel

  • Time-consuming deployment and need for frequent upgrades

Industry trends

  • Mergers and acquisitions: the most adopted strategy

  • Technological advances

  • New use case: the opioid epidemic crisis

  • End User Trends: Adoption of Healthcare Fraud Analysis Solutions by Pharmacy Benefit Managers

Companies mentioned

  • CGI inc.

  • Changing health care

  • Codoxo

  • Conduent Incorporated

  • Cotiviti, Inc.

  • DXC technology

  • Exlservice Holdings, Inc.

  • Fair Isaac Corporation

  • Fraudlens, Inc.

  • Shiver

  • H2O.Ai

  • HCL Technologies Limited

  • Anti-fraud shield in the health sector

  • HMS Holdings Corp.

  • IBM Company

  • Lexisnexis (part of the Relx group)

  • Multiplan

  • Northrop Grumman Company

  • Optum, Inc. (part of the UnitedHealth group)

  • OSP Laboratories

  • Pondera Solutions, Inc. (a subsidiary of Thomson Reuters Corporation)

  • Qlarant, Inc.

  • SAS Institute Inc.

  • Sharecare, Inc. (a subsidiary of Falcon Capital Acquisition Corp.)

  • Wipro Limited

For more information on this report, visit https://www.researchandmarkets.com/r/1zp9gb


Source link

Share.

Comments are closed.