The global healthcare fraud detection market size accounted for US$ 2.02 billion in 2023 and is projected to reach around USD 6.64 billion by 2033, growing at a CAGR of 12.65% from 2024 to 2033.
Key Points
- By region, North America dominated the market in 2023.
- By region, Asia Pacific is expected to grow at a significant rate during the forecast period.
- By type, the descriptive analytics segment dominated the market in 2023.
- By type, the predictive analytics segment is expected to grow at a notable pace during the forecast period.
- By application, the review of the insurance claim segment dominated in 2023.
- By application, the payment integrity segment is expected to grow at a significant rate in the market during the anticipated period.
- By end-user, the healthcare payers segment held the largest share of the market in 2023.
Report Summary
The global healthcare fraud detection market report provides a Point-by-Point and In-Depth analysis of global market size, regional and country-level market size, market share, segmentation market growth, competitive landscape, sales analysis, opportunities analysis, strategic market growth analysis, the impact of domestic and global market key players, value chain optimization, trade regulations, recent developments, product launches, area marketplace expanding, and technological innovations.
The study offers a comprehensive analysis on diverse features, including production capacities, demand, product developments, revenue generation, and sales in the healthcare fraud detection market across the globe.
A comprehensive estimate on the healthcare fraud detection market has been provided through an optimistic scenario as well as a conservative scenario, taking into account the sales of healthcare fraud detection during the forecast period. Price point comparison by region with global average price is also considered in the study.
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Healthcare Fraud Detection Market Scope
| Report Coverage | Details |
| Growth Rate from 2024 to 2033 | CAGR of 12.65% |
| Global Market Size in 2023 | USD 2.02 Billion |
| Global Market Size by 2033 | USD 6.64 Billion |
| U.S. Market Size in 2023 | USD 550 Million |
| U.S. Market Size by 2033 | USD 1,810 Million |
| Base Year | 2023 |
| Forecast Period | 2024 to 2033 |
| Segments Covered | By Type, By Application, and By End-user |
| Regions Covered | North America, Europe, Asia-Pacific, Latin America, and Middle East & Africa |
Key Highlights:
Reports Coverage: It incorporates key market sections, key makers secured, the extent of items offered in the years considered, worldwide containerized healthcare fraud detection market and study goals. Moreover, it contacts the division study gave in the report based on the sort of item and applications.
Market Outline: This area stresses the key investigations, market development rate, serious scene, market drivers, patterns, and issues notwithstanding the naturally visible pointers.
Market Production by Region: The report conveys information identified with import and fare, income, creation, and key players of every single local market contemplated are canvassed right now.
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Market Players
The report includes the profiles of key healthcare fraud detection market companies along with their SWOT analysis and market strategies. In addition, the report focuses on leading industry players with information such as company profiles, components and services offered, financial information, key development in past five years.
Recent Developments
- In February 2024, BharatGPT and Vizzhy are about to announce the launch of Healthcare LLM; VizzhyGPT is a multimodal model with a vision of automating diverse hospital processes in the clinical and non-clinical realm.
- In January 2024, Healthcare Fraud Shield (HCFS), one of the leading firms that provide fraud, waste, abuse, and error (FWAE) protection solutions to the health insurance market, launched FWA360Leads®, the latest solution that automatically prioritizes and identifies fraud, waste, abuse, and error (FWAE) leads as per their severity and importance.
Healthcare Fraud Detection Market Companies
- CGI Group
- Conduent
- DXC Technology Company
- EXLSERVICE Holdings Inc.
- Fair ISAAC Corporation
- HCL Technologies
- International Business Machines Corporation (IBM)
- LexisNexis
- McKesson Corporation
- Northrop Grumman
- Optum
- OSP Labs
- SAS Institute Inc.
- Scioinspire CORP.
- UNITEDHEALTH Group
- Verscend Technologies
- WIPRO Limited
Segments Covered in the Report
By Type
- Descriptive Analytics
- Predictive Analytics
- Prescriptive Analytics
By Application
- Review of Insurance Claims
- Payment Integrity
By End-user
- Private Insurance Payers
- Government Agencies
Regional Segmentation
- North America (U.S., Canada, Mexico)
- Europe (Germany, France, U.K., Italy, Spain, Rest of Europe)
- Asia-Pacific (China, Japan, India, Southeast Asia and Rest of APAC)
- Latin America (Brazil and Rest of Latin America)
- Middle East and Africa (GCC, North Africa, South Africa, Rest of MEA)
Research Methodology
Secondary Research
It involves company databases such as Hoover’s: This assists us to recognize financial information, the structure of the market participants and industry’s competitive landscape.
The secondary research sources referred in the process are as follows:
- Governmental bodies, and organizations creating economic policies
- National and international social welfare institutions
- Company websites, financial reports and SEC filings, broker and investor reports
- Related patent and regulatory databases
- Statistical databases and market reports
- Corporate Presentations, news, press release, and specification sheet of Manufacturers
Primary Research
Primary research includes face-to-face interviews, online surveys, and telephonic interviews.
- Means of primary research: Email interactions, telephonic discussions and Questionnaire-based research etc.
- In order to validate our research findings and analysis, we conduct primary interviews of key industry participants. Insights from primary respondents help in validating the secondary research findings. It also develops Research Team’s expertise and market understanding.
TABLE OF CONTENT
Chapter 1. Introduction
1.1. Research Objective
1.2. Scope of the Study
1.3. Definition
Chapter 2. Research Methodology (Premium Insights)
2.1. Research Approach
2.2. Data Sources
2.3. Assumptions & Limitations
Chapter 3. Executive Summary
3.1. Market Snapshot
Chapter 4. Market Variables and Scope
4.1. Introduction
4.2. Market Classification and Scope
4.3. Industry Value Chain Analysis
4.3.1. Raw Material Procurement Analysis
4.3.2. Sales and Distribution Channel Analysis
4.3.3. Downstream Buyer Analysis
Chapter 5. COVID 19 Impact on Healthcare Fraud Detection Market
5.1. COVID-19 Landscape: Healthcare Fraud Detection Industry Impact
5.2. COVID 19 – Impact Assessment for the Industry
5.3. COVID 19 Impact: Global Major Government Policy
5.4. Market Trends and Opportunities in the COVID-19 Landscape
Chapter 6. Market Dynamics Analysis and Trends
6.1. Market Dynamics
6.1.1. Market Drivers
6.1.2. Market Restraints
6.1.3. Market Opportunities
6.2. Porter’s Five Forces Analysis
6.2.1. Bargaining power of suppliers
6.2.2. Bargaining power of buyers
6.2.3. Threat of substitute
6.2.4. Threat of new entrants
6.2.5. Degree of competition
Chapter 7. Competitive Landscape
7.1.1. Company Market Share/Positioning Analysis
7.1.2. Key Strategies Adopted by Players
7.1.3. Vendor Landscape
7.1.3.1. List of Suppliers
7.1.3.2. List of Buyers
Chapter 8. Global Healthcare Fraud Detection Market, By Type
8.1. Healthcare Fraud Detection Market, by Type, 2024-2033
8.1.1 Descriptive Analytics
8.1.1.1. Market Revenue and Forecast (2021-2033)
8.1.2. Predictive Analytics
8.1.2.1. Market Revenue and Forecast (2021-2033)
8.1.3. Prescriptive Analytics
8.1.3.1. Market Revenue and Forecast (2021-2033)
Chapter 9. Global Healthcare Fraud Detection Market, By Application
9.1. Healthcare Fraud Detection Market, by Application, 2024-2033
9.1.1. Review of Insurance Claims
9.1.1.1. Market Revenue and Forecast (2021-2033)
9.1.2. Payment Integrity
9.1.2.1. Market Revenue and Forecast (2021-2033)
Chapter 10. Global Healthcare Fraud Detection Market, By End-user
10.1. Healthcare Fraud Detection Market, by End-user, 2024-2033
10.1.1. Private Insurance Payers
10.1.1.1. Market Revenue and Forecast (2021-2033)
10.1.2. Government Agencies
10.1.2.1. Market Revenue and Forecast (2021-2033)
Chapter 11. Global Healthcare Fraud Detection Market, Regional Estimates and Trend Forecast
11.1. North America
11.1.1. Market Revenue and Forecast, by Type (2021-2033)
11.1.2. Market Revenue and Forecast, by Application (2021-2033)
11.1.3. Market Revenue and Forecast, by End-user (2021-2033)
11.1.4. U.S.
11.1.4.1. Market Revenue and Forecast, by Type (2021-2033)
11.1.4.2. Market Revenue and Forecast, by Application (2021-2033)
11.1.4.3. Market Revenue and Forecast, by End-user (2021-2033)
11.1.5. Rest of North America
11.1.5.1. Market Revenue and Forecast, by Type (2021-2033)
11.1.5.2. Market Revenue and Forecast, by Application (2021-2033)
11.1.5.3. Market Revenue and Forecast, by End-user (2021-2033)
11.2. Europe
11.2.1. Market Revenue and Forecast, by Type (2021-2033)
11.2.2. Market Revenue and Forecast, by Application (2021-2033)
11.2.3. Market Revenue and Forecast, by End-user (2021-2033)
11.2.4. UK
11.2.4.1. Market Revenue and Forecast, by Type (2021-2033)
11.2.4.2. Market Revenue and Forecast, by Application (2021-2033)
11.2.4.3. Market Revenue and Forecast, by End-user (2021-2033)
11.2.5. Germany
11.2.5.1. Market Revenue and Forecast, by Type (2021-2033)
11.2.5.2. Market Revenue and Forecast, by Application (2021-2033)
11.2.5.3. Market Revenue and Forecast, by End-user (2021-2033)
11.2.6. France
11.2.6.1. Market Revenue and Forecast, by Type (2021-2033)
11.2.6.2. Market Revenue and Forecast, by Application (2021-2033)
11.2.6.3. Market Revenue and Forecast, by End-user (2021-2033)
11.2.7. Rest of Europe
11.2.7.1. Market Revenue and Forecast, by Type (2021-2033)
11.2.7.2. Market Revenue and Forecast, by Application (2021-2033)
11.2.7.3. Market Revenue and Forecast, by End-user (2021-2033)
11.3. APAC
11.3.1. Market Revenue and Forecast, by Type (2021-2033)
11.3.2. Market Revenue and Forecast, by Application (2021-2033)
11.3.3. Market Revenue and Forecast, by End-user (2021-2033)
11.3.4. India
11.3.4.1. Market Revenue and Forecast, by Type (2021-2033)
11.3.4.2. Market Revenue and Forecast, by Application (2021-2033)
11.3.4.3. Market Revenue and Forecast, by End-user (2021-2033)
11.3.5. China
11.3.5.1. Market Revenue and Forecast, by Type (2021-2033)
11.3.5.2. Market Revenue and Forecast, by Application (2021-2033)
11.3.5.3. Market Revenue and Forecast, by End-user (2021-2033)
11.3.6. Japan
11.3.6.1. Market Revenue and Forecast, by Type (2021-2033)
11.3.6.2. Market Revenue and Forecast, by Application (2021-2033)
11.3.6.3. Market Revenue and Forecast, by End-user (2021-2033)
11.3.7. Rest of APAC
11.3.7.1. Market Revenue and Forecast, by Type (2021-2033)
11.3.7.2. Market Revenue and Forecast, by Application (2021-2033)
11.3.7.3. Market Revenue and Forecast, by End-user (2021-2033)
11.4. MEA
11.4.1. Market Revenue and Forecast, by Type (2021-2033)
11.4.2. Market Revenue and Forecast, by Application (2021-2033)
11.4.3. Market Revenue and Forecast, by End-user (2021-2033)
11.4.4. GCC
11.4.4.1. Market Revenue and Forecast, by Type (2021-2033)
11.4.4.2. Market Revenue and Forecast, by Application (2021-2033)
11.4.4.3. Market Revenue and Forecast, by End-user (2021-2033)
11.4.5. North Africa
11.4.5.1. Market Revenue and Forecast, by Type (2021-2033)
11.4.5.2. Market Revenue and Forecast, by Application (2021-2033)
11.4.5.3. Market Revenue and Forecast, by End-user (2021-2033)
11.4.6. South Africa
11.4.6.1. Market Revenue and Forecast, by Type (2021-2033)
11.4.6.2. Market Revenue and Forecast, by Application (2021-2033)
11.4.6.3. Market Revenue and Forecast, by End-user (2021-2033)
11.4.7. Rest of MEA
11.4.7.1. Market Revenue and Forecast, by Type (2021-2033)
11.4.7.2. Market Revenue and Forecast, by Application (2021-2033)
11.4.7.3. Market Revenue and Forecast, by End-user (2021-2033)
11.5. Latin America
11.5.1. Market Revenue and Forecast, by Type (2021-2033)
11.5.2. Market Revenue and Forecast, by Application (2021-2033)
11.5.3. Market Revenue and Forecast, by End-user (2021-2033)
11.5.4. Brazil
11.5.4.1. Market Revenue and Forecast, by Type (2021-2033)
11.5.4.2. Market Revenue and Forecast, by Application (2021-2033)
11.5.4.3. Market Revenue and Forecast, by End-user (2021-2033)
11.5.5. Rest of LATAM
11.5.5.1. Market Revenue and Forecast, by Type (2021-2033)
11.5.5.2. Market Revenue and Forecast, by Application (2021-2033)
11.5.5.3. Market Revenue and Forecast, by End-user (2021-2033)
Chapter 12. Company Profiles
12.1. CGI Group
12.1.1. Company Overview
12.1.2. Product Offerings
12.1.3. Financial Performance
12.1.4. Recent Initiatives
12.2. Conduent
12.2.1. Company Overview
12.2.2. Product Offerings
12.2.3. Financial Performance
12.2.4. Recent Initiatives
12.3. DXC Technology Company
12.3.1. Company Overview
12.3.2. Product Offerings
12.3.3. Financial Performance
12.3.4. Recent Initiatives
12.4. EXLSERVICE Holdings Inc.
12.4.1. Company Overview
12.4.2. Product Offerings
12.4.3. Financial Performance
12.4.4. Recent Initiatives
12.5. Fair ISAAC Corporation
12.5.1. Company Overview
12.5.2. Product Offerings
12.5.3. Financial Performance
12.5.4. Recent Initiatives
12.6. HCL Technologies
12.6.1. Company Overview
12.6.2. Product Offerings
12.6.3. Financial Performance
12.6.4. Recent Initiatives
12.7. International Business Machines Corporation (IBM)
12.7.1. Company Overview
12.7.2. Product Offerings
12.7.3. Financial Performance
12.7.4. Recent Initiatives
12.8. LexisNexis
12.8.1. Company Overview
12.8.2. Product Offerings
12.8.3. Financial Performance
12.8.4. Recent Initiatives
12.9. McKesson Corporation
12.9.1. Company Overview
12.9.2. Product Offerings
12.9.3. Financial Performance
12.9.4. Recent Initiatives
12.10. Northrop Grumman
12.10.1. Company Overview
12.10.2. Product Offerings
12.10.3. Financial Performance
12.10.4. Recent Initiatives
Chapter 13. Research Methodology
13.1. Primary Research
13.2. Secondary Research
13.3. Assumptions
Chapter 14. Appendix
14.1. About Us
14.2. Glossary of Terms
Thanks for reading you can also get individual chapter-wise sections or region-wise report versions such as North America, Europe, or the Asia Pacific.
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