Overview


According to FutureWise analysis the market for healthcare fraud analytics in 2023 is US$ 2.42 billion, and is expected to reach US$ 16.27 billion by 2031 at a CAGR of 26.92%.

The growth of the market can be attributed to the rising number of patients obtaining healthcare insurance, increasing healthcare-related fradulent activities and burgeoning in the returns on investments.

FutureWise Market Research has instantiated a report that provides an intricate analysis of Healthcare Fraud Analytics Market trends that shall affect the overall market growth. Furthermore, it includes detailed information on the graph of profitability, SWOT analysis, market share and regional proliferation of this business. Moreover, the report offers insights on the current stature of prominent market players in the competitive landscape analysis of this market.

According to the research study conducted by FutureWise research analysts, the Healthcare Fraud Analytics Market is anticipated to attain substantial growth by the end of the forecast period. The report explains that this business is predicted to register a noteworthy growth rate over the forecast period. This report provides crucial information pertaining to the total valuation that is presently held by this industry and it also lists the segmentation of the market along with the growth opportunities present across this business vertical.
  • IBM
  • Optum (A Part of Unitedhealth Group)
  • Cotiviti Holdings, Inc.
  • Fair Isaac Corporation
  • SAS Institute
  • Change Healthcare
  • EXL Service Holdings, Inc.
  • Wipro
  • Conduent, Inc.
  • HCL Technologies
  • CGI Group
  • DXC Technology Company
  • Northrop Grumman Corporation
  • LexisNexis (A Part of Relx Group)
  • Pondera Solutions

(Note: The list of the major players will be updated with the latest market scenario and trends)

By Solution Type

  • Descriptive Analytics
  • Predictive Analytics
  • Prescriptive Analytics

By Application

  • Insurance Claims Review
  • Postpayment Review
  • Prepayment Review
  • Pharmacy Billing Misuse
  • Payment Integrity
  • Other Applications

By Delivery

  • On-Premise Delivery Models
  • On-Demand Delivery Models

By End User

  • Public and Government Agencies
  • Private Insurance Payers
  • Third-Party Service Providers
  • Employers

By Region

  • North America
  • Latin America
  • Europe
  • Asia-Pacific
  • Middle East and Africa
  • Tier 1 players- established companies in the market with a major market share
  • Tier 2 players
  • Emerging players which are growing rapidly
  • New Entrants
  • Growth prospects
  • SWOT analysis
  • Key trends
  • Key data-points affecting market growth
  • To provide an exhaustive analysis on the Healthcare Fraud Analytics Market By Solution Type, By Application, By Delivery, By End User, and By Region.
  • To cater comprehensive information on factors impacting market growth (drivers, restraints, opportunities, and industry-specific restraints)
  • To evaluate and forecast micro-markets and the overall market
  • To predict the market size, in key regions— North America, Europe , Asia Pacific, Latin America and Middle East and Africa
  • To record and evaluate competitive landscape mapping- product launches, technological advancements, mergers and expansions
  • We have a flexible delivery model and you can suggest changes in the scope/table of content as per your requirement
  • The customization Mobility Care offered are free of charge with purchase of any license of the report
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Table of Contents


  • 1.   Market Introduction

    •   1. Objectives of the Study
        2. Market Definition
        3. Market Scope
         3.1. Years Considered for the Study
         3.2. Market Covered
        4. Currency
        5. Limitations
        6. Stakeholders

  • 2.   Research Methodology

    •   1. Research Data
         1.1. Secondary Data
          1.1.1. Key Data from Secondary Sources
         1.2. Primary Data
          1.2.1. Key Data from Primary Sources
        2. Market Size Estimation
        3. Market Breakdown and Data Triangulation
        4. Assumptions for the Study

  • 3.   Executive Summary
    •   1. Market Outlook
        2. Segment Outlook
        3. Competitive Insights
  • 4.   Healthcare Fraud Analytics Market Variables, Trends and Scope

    •   1. Market Lineage Outlook
        2. Penetration and Growth Prospect Mapping
        3. Industry Value Chain Analysis
        4. Cost Analysis Breakdown
        5. Technology Overview
        6. Regulatory Framework
         6.1. Reimbursement Framework
         6.2. Standards and Compliances

  • 5.   Market Overview
    •   1. Market Dynamics
         1.1. Market Driver Analysis
          1.1.1. Increasing focus of Healthcare Fraud Analytics Companies on Brand Protection
          1.1.2. Untapped Opportunities in Emerging Regions
         1.2. Market Restraint Analysis
          1.2.1. High Cost Associated with Implementation of Predictive Analysis
         1.3. Industry Challenges
          1.3.1. Presence of Ambiguous Regulatory Framework
  • 6.   Healthcare Fraud Analytics Market Analysis Tools
    •   1. Industry Analysis - Porter’s
         1.1. Supplier Power
         1.2. Buyer Power
         1.3. Substitution Threat
         1.4. Threat from New Entrants
         1.5. Competitive Rivalry
        2. Pestel Analysis
         2.1. Political Landscape
         2.2. Environmental Landscape
         2.3. Social Landscape
         2.4. Technology Landscape
         2.5. Legal Landscape
        3. Major Deals And Strategic Alliances Analysis
         3.1. Joint Ventures
         3.2. Mergers and Acquisitions
         3.3. Licensing and Partnership
         3.4. Technology Collaborations
         3.5. Strategic Divestments
        4. Market Entry Strategies
        5. Case Studies
  • 7.   Healthcare Fraud Analytics Market, By Solution Type Historical Analysis and Forecast 2023-2031 (USD Million)

    •   1. Descriptive Analytics
        2. Predictive Analytics
        3. Prescriptive Analytics

  • 8.   Healthcare Fraud Analytics Market, By Application Historical Analysis and Forecast 2023-2031 (USD Million)

    •   1. Insurance Claims review
         1.1. Postpayment Review
         1.2. Prepayment Review
        2. Pharmacy Billing Misuse
        3. Payment Integrity
        4. Other Applications

  • 9.   Healthcare Fraud Analytics Market, By Delivery Historical Analysis and Forecast 2023-2031 (USD Million)

    •   1. On-Premise Delivery Models
        2. On-Demand Delivery Models

  • 10.   Healthcare Fraud Analytics Market, By End User Historical Analysis and Forecast 2023-2031 (USD Million)

    •   1. Public and Government Agencies
        2. Private Insurance Payers
        3. Third Party Service Providers
        4. Employers

  • 11.   North America Healthcare Fraud Analytics Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)

    •   1. Introduction
        2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         2.1. U.S.A
         2.2. Canada
         2.3. Mexico
        3. Market Size (USD Million) Forecast for North America 2023-2031

  • 12.   Latin America Healthcare Fraud Analytics Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)

    •   1. Introduction
        2. Regional Market Trends
        3. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         3.1. Brazil
         3.2. Venezuela
         3.3. Argentina
         3.4. Rest of Latin America
        4. Market Size (USD Million) Forecast for Latin America 2023-2031

  • 13.   Europe Healthcare Fraud Analytics Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)

    •   1. Introduction
        2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         2.1. Germany
         2.2. U.K
         2.3. France
         2.4. Italy
         2.5. Spain
         2.6. Russia
         2.7. Poland
         2.8. Switzerland
         2.9. Rest of Western Europe
        3. Market Size (USD Million) Forecast for Europe 2023-2031

  • 14.   Asia Pacific Healthcare Fraud Analytics Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)

    •   1. Introduction
        2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         2.1. Japan
         2.2. China
         2.3. Singapore
         2.4. India
         2.5. Australia and New Zealand
         2.6. ASEAN
         2.7. South Korea
         2.8. Rest of Asia Pacific
        3. Market Size (USD Million) Forecast for Asia Pacific 2023-2031

  • 15.   Middle East and Africa Healthcare Fraud Analytics Market Analysis 2017-2022 and Forecast 2023-2031 (USD Million)

    •   1. Introduction
        2. Historical Market Size (USD Million) Analysis By Country, 2017-2022
         2.1. GCC
         2.2. Israel
         2.3. South Africa
         2.4. Rest of MEA
        3. Market Size (USD Million) Forecast for MEA 2023-2031

  • 16.   Market Share Analysis and Competitive Landscape
    •   1. Global Landscape - Key Players, Revenue and Presence
        2. Global Share Analysis - Key Players (Tier 1, Tier 2, Tier 3)
        3. Global Emerging Companies
        4. North America - Market Share Analysis and Key Regional Players
        5. Europe - Market Share Analysis and Key Regional Players
        6. Asia Pacific - Market Share Analysis and Key Regional Players
        7. Global Key Player - Growth Matrix
  • 17.   Company Profiles (Competition Dashboard, Competitors Deep Dive, Product Connected Devices and Technology Portfolio, Financial Layouts)

    •   1. IBM
         1.1. Company Overview
         1.2. Product Portfolio
         1.3. SWOT Analysis
         1.4. Financial Overview
         1.5. Strategic Overview
        2. Optum
         2.1. Company Overview
         2.2. Product Portfolio
         2.3. SWOT Analysis
         2.4. Financial Overview
         2.5. Strategic Overview
        3. Cotiviti Holdings, Inc.
         3.1. Company Overview
         3.2. Product Portfolio
         3.3. SWOT Analysis
         3.4. Financial Overview
         3.5. Strategic Overview
        4. Fair Isaac Corporation
         4.1. Company Overview
         4.2. Product Portfolio
         4.3. SWOT Analysis
         4.4. Financial Overview
         4.5. Strategic Overview
        5. SAS Institute
         5.1. Company Overview
         5.2. Product Portfolio
         5.3. SWOT Analysis
         5.4. Financial Overview
         5.5. Strategic Overview
        6. Change Healthcare
         6.1. Company Overview
         6.2. Product Portfolio
         6.3. SWOT Analysis
         6.4. Financial Overview
         6.5. Strategic Overview
        7. EXL Service Holdings, Inc.
         7.1. Company Overview
         7.2. Product Portfolio
         7.3. SWOT Analysis
         7.4. Financial Overview
         7.5. Strategic Overview
        8. Wipro
         8.1. Company Overview
         8.2. Product Portfolio
         8.3. SWOT Analysis
         8.4. Financial Overview
         8.5. Strategic Overview
        9. Conduent, Inc.
         9.1. Company Overview
         9.2. Product Portfolio
         9.3. SWOT Analysis
         9.4. Financial Overview
         9.5. Strategic Overview
        10. HCL Technologies
         10.1. Company Overview
         10.2. Product Portfolio
         10.3. SWOT Analysis
         10.4. Financial Overview
         10.5. Strategic Overview
        11. CGI Group
         11.1. Company Overview
         11.2. Product Portfolio
         11.3. SWOT Analysis
         11.4. Financial Overview
         11.5. Strategic Overview
        12. DXC Technology Company
         12.1. Company Overview
         12.2. Product Portfolio
         12.3. SWOT Analysis
         12.4. Financial Overview
         12.5. Strategic Overview
        13. Northrop Grumman Corporation
         13.1. Company Overview
         13.2. Product Portfolio
         13.3. SWOT Analysis
         13.4. Financial Overview
         13.5. Strategic Overview
        14. LexisNexis (A Part of Relx Group)
         14.1. Company Overview
         14.2. Product Portfolio
         14.3. SWOT Analysis
         14.4. Financial Overview
         14.5. Strategic Overview
        15. Pondera Solutions
         15.1. Company Overview
         15.2. Product Portfolio
         15.3. SWOT Analysis
         15.4. Financial Overview
         15.5. Strategic Overview

  • 18.   Pre and Post COVID-19 Impact
    •   1. Positive influence on the healthcare industry
        2. The financial disruption of the manufacturing sector
        3. Impact of COVID-19 on emerging companies
        4. Significant mandates in the healthcare regulations initiated by administrations
        5. The overall economic slowdown of the developing and developed nations
  • 19.   FutureWise SME Key Takeaway Points for Client

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