The report "Healthcare Fraud Analytics Market by Solution Type (Descriptive, Predictive, Prescriptive), Application (Insurance Claim (Postpayment, Prepayment), Payment Integrity), Delivery (On-premise, Cloud), End User (Insurance, Government) - Global Forecast to 2025", is projected to reach USD 4.6 billion by 2025 from USD 1.2 billion in 2020, at a CAGR of 29.8% during the forecast period.
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“The prescriptive analytics segment registered the highest growth during the forecast period.”
Fraud analytics solutions vary from vendor to vendor. Some vendors offer rule-based models while others offer AI-based technologies, but broadly, these solutions are classified based on the type of analytics used—descriptive analytics, predictive analytics, and prescriptive analytics. The prescriptive analytics segment registered the highest growth in the healthcare fraud analytics market during the forecast period.
“In 2019, public & government agencies accounted for the largest share of the healthcare fraud analytics market, by end user.”
Based on end user, the healthcare fraud detection market is segmented into public & government agencies, private insurance payers, employers, and third-party service providers. The public & government agencies segment accounted for the largest share of the healthcare fraud analytics market in 2019.
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Key Players
IBM Corporation (US), Optum (US), SAS Institute (US), Change Healthcare (US), EXL Service Holdings (US), Cotiviti (US), Wipro Limited (Wipro) (India), Conduent (US), HCL (India), Canadian Global Information Technology Group (Canada), DXC Technology Company (US), Northrop Grumman Corporation (US), LexisNexis Group (US), and Pondera Solutions (US).
IBM is a leading player in the healthcare fraud detection market. The leading position of the company is attributed to its robust product portfolio. The company offers exhaustive healthcare fraud analytic solutions for application in healthcare. The company has a strong presence in the commercial and government healthcare payer markets. For instance, since 2005, the company has invested USD 24 billion in the development of its Big Data and Analytics software and services capabilities. For instance, in April 2016, IBM acquired Truven (US), a provider of cloud-based healthcare data, analytics, and insights.
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