Overview

Healthcare Fraud Analytics Market is poised to register a CAGR of 26.7% during the forecast period 2022 to 2028. 

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.

Major players included in the Healthcare Fraud Analytics Market:

• 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)

Healthcare Fraud Analytics Market Segmentation:

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

Competitive Landscape:

• Tier 1 players- established companies in the market with a major market share
• Tier 2 players
• Emerging players which are growing rapidly
• New Entrants

FutureWise Key Takeaways:

• Growth prospects
• SWOT analysis
• Key trends
• Key data-points affecting market growth

Objectives of the Study:

• 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

Flexible Delivery Model:

• 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
• You can directly share your requirements/changes to the current table of content to: sales@futurewiseresearch.com

Table of Contents

1. Market Introduction
     1.1 Objectives of the Study
     1.2 Market Definition 
     1.3 Market Scope 
           1.3.1 Years Considered for the Study
           1.3.2 Market Covered
     1.4 Currency 
     1.5 Limitations 
     1.6 Stakeholders
2. Research Methodology
    2.1 Research Data 
          2.1.1 Secondary Data
                   2.1.1.1 Key Data from Secondary Sources
          2.1.2 Primary Data
                   2.1.2.1 Key Data from Primary Sources
    2.2 Market Size Estimation 
    2.3 Market Breakdown and Data Triangulation 
    2.4 Assumptions for the Study 
3. Executive Summary 
        3.1 Market Outlook
        3.2 Segment Outlook
        3.3 Competitive Insights
4. Healthcare Fraud Analytics Market Variables, Trends & Scope
       4.1. Market Lineage Outlook
       4.2. Penetration and Growth Prospect Mapping
       4.3. Industry Value Chain Analysis
       4.4. Cost Analysis Breakdown
       4.5. Technology Overview
       4.6. Regulatory Framework
                 4.6.1. Reimbursement Framework
                 4.6.2. Standards and Compliances
5. Market Overview
     5.1. Market Dynamics
                  5.1.1. Market Driver Analysis
                            5.1.1.1. Increasing focus of Healthcare Fraud Analytics Companies on Brand Protection                                                              
                            5.1.1.2. Untapped Opportunities in Emerging Regions
                  5.1.2. Market Restraint Analysis
                            5.1.2.1. High Cost Associated with Implementation of Predictive Analysis
                  5.1.3. Industry Challenges
                            5.1.3.1. Presence of Ambiguous Regulatory Framework
6. Healthcare Fraud Analytics Market Analysis Tools
         6.1. Industry Analysis - Porter’s
               6.1.1. Supplier Power
               6.1.2. Buyer Power
               6.1.3. Substitution Threat
               6.1.4. Threat from New Entrants
               6.1.5. Competitive Rivalry
         6.2. Pestel Analysis
               6.2.1. Political Landscape
               6.2.2. Environmental Landscape
               6.2.3. Social Landscape
               6.2.4. Technology Landscape
               6.2.5. Legal Landscape
         6.3. Major Deals And Strategic Alliances Analysis
                6.3.1. Joint Ventures
                6.3.2. Mergers and Acquisitions
                6.3.3. Licensing and Partnership
                6.3.4. Technology Collaborations
                6.3.5. Strategic Divestments
         6.4. Market Entry Strategies
         6.5. Case Studies
7. Healthcare Fraud Analytics Market, By Solution Type Historical Analysis and Forecast 2022-2028 (USD Million)
        7.1. Descriptive Analytics
        7.2. Predictive Analytics
        7.3. Prescriptive Analytics
8. Healthcare Fraud Analytics Market, By Application Historical Analysis and Forecast 2022-2028 (USD Million)
        8.1. Insurance Claims review
            8.1.1. Postpayment Review
            8.1.2. Prepayment Review
        8.2. Pharmacy Billing Misuse
        8.3. Payment Integrity
        8.4. Other Applications
9. Healthcare Fraud Analytics Market, By Delivery Historical Analysis and Forecast 2022-2028 (USD Million)
        9.1. On-Premise Delivery Models
        9.2. On-Demand Delivery Models
10. Healthcare Fraud Analytics Market, By End User Historical Analysis and Forecast 2022-2028 (USD Million)
        10.1. Public and Government Agencies
        10.2. Private Insurance Payers
        10.3. Third Party Service Providers
        10.4. Employers
11.  North America Market Analysis 2016–2020 and Forecast 2022–2028 (USD Million)
        11.1. Introduction
        11.2. Historical Market Size (USD Million) Analysis By Country, 2016-2020
            10.2.1. U.S.A
            10.2.2. Canada
            10.2.3. Mexico
        11.3. Market Size (USD Million) Forecast for North America 2022-2028
12. Latin America Market Analysis 2016–2020 and Forecast 2022–2028 (USD Million)
        12.1. Introduction
        12.2. Regional Market Trends
        12.3. Historical Market Size (USD Million) Analysis By Country, 2016-2020
            12.3.1. Brazil
            12.3.2. Venezuela
            12.3.3. Argentina
            12.3.4. Rest of Latin America
         12.4. Market Size (USD Million) Forecast for Latin America 2022-2028
13. Europe Market Analysis 2016–2020 and Forecast 2022–2028 (USD Million)
         13.1. Introduction
         13.2. Historical Market Size (USD Million) Analysis By Country, 2016-2020
            13.2.1. Germany
            13.2.2. U.K
            13.2.3. France
            13.2.4. Italy
            13.2.5. Spain
            13.2.6. Russia
            13.2.7. Poland
            13.2.8. Switzerland
            13.2.9. Rest of Western Europe
14. Asia Pacific Market Analysis 2016–2020 and Forecast 2022–2028 (USD Million)
         14.1. Introduction
         14.2. Historical Market Size (USD Million) Analysis By Country, 2016-2020
             14.2.1. Japan
             14.2.2. China
             14.2.3. Singapore
             14.2.4. India
             14.2.5. Australia and New Zealand
             14.2.6. ASEAN
             14.2.7. South Korea
             14.2.8. Rest of Asia Pacific
         14.3. Market Size (USD Million) Forecast for Asia Pacific 2022-2028
15. Middle East and Africa Market Analysis 2016–2020 and Forecast 2022–2028 (USD Million)
         15.1. Introduction
         15.2. Historical Market Size (USD Million) Analysis By Country, 2016-2020
             15.2.1. GCC
             15.2.2. Israel
             15.2.3. South Africa
             15.2.4. Rest of MEA
         15.3. Market Size (USD Million) Forecast for MEA 2022-2028
16. Market Share Analysis and Competitive Landscape   
    16.1. Global Landscape - Key Players, Revenue and Presence
    16.2. Global Share Analysis - Key Players (Tier 1, Tier 2, Tier 3)
    16.3. Global Emerging Companies
    16.4. North America - Market Share Analysis and Key Regional Players
    16.5. Europe - Market Share Analysis and Key Regional Players
    16.6. Asia Pacific - Market Share Analysis and Key Regional Players
    16.7. Global Key Player - Growth Matrix
17. Company Profiles (Competition Dashboard, Competitors Deep Dive, Product Connected Devices and Technology Portfolio, Financial Layouts)
         17.1. IBM
                17.1.1. Company Overview
                17.1.2. Product Portfolio
                17.1.3. SWOT Analysis
                17.1.4. Financial Overview
                17.1.5. Strategic Overview
         17.2. Optum
                17.2.1. Company Overview
                17.2.2. Product Portfolio
                17.2.3. SWOT Analysis
                17.2.4. Financial Overview
                17.2.5. Strategic Overview
         17.3. Cotiviti Holdings, Inc.
                17.3.1. Company Overview
                17.3.2. Product Portfolio
                17.3.3. SWOT Analysis
                17.3.4. Financial Overview
                17.3.5. Strategic Overview
         17.4. Fair Isaac Corporation
                17.4.1. Company Overview
                17.4.2. Product Portfolio
                17.4.3. SWOT Analysis
                17.4.4. Financial Overview
                17.4.5. Strategic Overview
         17.5. SAS Institute
                17.5.1. Company Overview
                17.5.2. Product Portfolio
                17.5.3. SWOT Analysis
                17.5.4. Financial Overview
                17.5.5. Strategic Overview
         17.6. Change Healthcare
                17.6.1. Company Overview
                17.6.2. Product Portfolio
                17.6.3. SWOT Analysis
                17.6.4. Financial Overview
                17.6.5. Strategic Overview
         17.7. EXL Service Holdings, Inc.
                17.7.1. Company Overview
                17.7.2. Product Portfolio
                17.7.3. SWOT Analysis
                17.7.4. Financial Overview
                17.7.5. Strategic Overview
         17.8. Wipro
                17.8.1. Company Overview
                17.8.2. Product Portfolio
                17.8.3. SWOT Analysis
                17.8.4. Financial Overview
                17.8.5. Strategic Overview
         17.9. Conduent, Inc.
                17.9.1. Company Overview
                17.9.2. Product Portfolio
                17.9.3. SWOT Analysis
                17.9.4. Financial Overview
                17.9.5. Strategic Overview
         17.10. HCL Technologies
                17.10.1. Company Overview
                17.10.2. Product Portfolio
                17.10.3. SWOT Analysis
                17.10.4. Financial Overview
                17.10.5. Strategic Overview
         17.11. CGI Group
                17.11.1. Company Overview
                17.11.2. Product Portfolio
                17.11.3. SWOT Analysis
                17.11.4. Financial Overview
                17.11.5. Strategic Overview
         17.12. DXC Technology Company
                17.12.1. Company Overview
                17.12.2. Product Portfolio
                17.12.3. SWOT Analysis
                17.12.4. Financial Overview
                17.12.5. Strategic Overview
         17.13. Northrop Grumman Corporation
                17.13.1. Company Overview
                17.13.2. Product Portfolio
                17.13.3. SWOT Analysis
                17.13.4. Financial Overview
                17.13.5. Strategic Overview
         17.14. LexisNexis (A Part of Relx Group)
                17.14.1. Company Overview
                17.14.2. Product Portfolio
                17.14.3. SWOT Analysis
                17.14.4. Financial Overview
                17.14.5. Strategic Overview
         17.15. Pondera Solutions
                17.15.1. Company Overview
                17.15.2. Product Portfolio
                17.15.3. SWOT Analysis
                17.15.4. Financial Overview
                17.15.5. Strategic Overview
18. Pre and Post COVID-19 Impact
    18.1. Positive influence on the healthcare industry
    18.2. The financial disruption of the manufacturing sector
    18.3. Impact of COVID-19 on emerging companies
    18.4. Significant mandates in the healthcare regulations initiated by administrations
    18.5. The overall economic slowdown of the developing and developed nations
19. FutureWise SME Key Takeaway Points for Client

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