Overview

Healthcare Fraud Analytics Market is estimated to value over USD 5.7 billion by 2027 end with a remarkable CAGR of over 27.8% during the forecast period 2020 to 2027.

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 and rest of the world
• 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. Global 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. Global 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. Global Healthcare Fraud Analytics Market, By Solution Type Historical Analysis and Forecast 2020-2027 (USD Million)
        7.1. Descriptive Analytics
        7.2. Predictive Analytics
        7.3. Prescriptive Analytics
8. Global Healthcare Fraud Analytics Market, By Application Historical Analysis and Forecast 2020-2027 (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. Global Healthcare Fraud Analytics Market, By Delivery Historical Analysis and Forecast 2020-2027 (USD Million)
        9.1. On-Premise Delivery Models
        9.2. On-Demand Delivery Models
10. Global Healthcare Fraud Analytics Market, By End User Historical Analysis and Forecast 2020-2027 (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 2015–2019 and Forecast 2020–2027 (USD Million)
        11.1. Introduction
        11.2. Historical Market Size (USD Million) Analysis By Country, 2015-2019
            10.2.1. U.S.A
            10.2.2. Canada
            10.2.3. Mexico
        11.3. Market Size (USD Million) Forecast for North America 2020-2027
12. Latin America Market Analysis 2015–2019 and Forecast 2020–2027 (USD Million)
        12.1. Introduction
        12.2. Regional Market Trends
        12.3. Historical Market Size (USD Million) Analysis By Country, 2015-2019
            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 2020-2027
13. Europe Market Analysis 2015–2019 and Forecast 2020–2027 (USD Million)
         13.1. Introduction
         13.2. Historical Market Size (USD Million) Analysis By Country, 2015-2019
            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 2015–2019 and Forecast 2020–2027 (USD Million)
         14.1. Introduction
         14.2. Historical Market Size (USD Million) Analysis By Country, 2015-2019
             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 2020-2027
15. Middle East and Africa Market Analysis 2015–2019 and Forecast 2020–2027 (USD Million)
         15.1. Introduction
         15.2. Historical Market Size (USD Million) Analysis By Country, 2015-2019
             15.2.1. Saudi Arabia
             15.2.2. UAE
             15.2.3. South Africa
             15.2.4. Egypt
         15.3. Market Size (USD Million) Forecast for MEA 2020-2027
16. Company Profiles (Competition Dashboard, Competitors Deep Dive, Product Connected Devices and Technology Portfolio, Financial Layouts)
         16.1. IBM
                16.1.1. Company Overview
                16.1.2. Product Portfolio
                16.1.3. SWOT Analysis
                16.1.4. Financial Overview
                16.1.5. Strategic Overview
         16.2. Optum
                16.2.1. Company Overview
                16.2.2. Product Portfolio
                16.2.3. SWOT Analysis
                16.2.4. Financial Overview
                16.2.5. Strategic Overview
         16.3. Cotiviti Holdings, Inc.
                16.3.1. Company Overview
                16.3.2. Product Portfolio
                16.3.3. SWOT Analysis
                16.3.4. Financial Overview
                16.3.5. Strategic Overview
         16.4. Fair Isaac Corporation
                16.4.1. Company Overview
                16.4.2. Product Portfolio
                16.4.3. SWOT Analysis
                16.4.4. Financial Overview
                16.4.5. Strategic Overview
         16.5. SAS Institute
                16.5.1. Company Overview
                16.5.2. Product Portfolio
                16.5.3. SWOT Analysis
                16.5.4. Financial Overview
                16.5.5. Strategic Overview
         16.6. Change Healthcare
                16.6.1. Company Overview
                16.6.2. Product Portfolio
                16.6.3. SWOT Analysis
                16.6.4. Financial Overview
                16.6.5. Strategic Overview
         16.7. EXL Service Holdings, Inc.
                16.7.1. Company Overview
                16.7.2. Product Portfolio
                16.7.3. SWOT Analysis
                16.7.4. Financial Overview
                16.7.5. Strategic Overview
         16.8. Wipro
                16.8.1. Company Overview
                16.8.2. Product Portfolio
                16.8.3. SWOT Analysis
                16.8.4. Financial Overview
                16.8.5. Strategic Overview
         16.9. Conduent, Inc.
                16.9.1. Company Overview
                16.9.2. Product Portfolio
                16.9.3. SWOT Analysis
                16.9.4. Financial Overview
                16.9.5. Strategic Overview
         16.10. HCL Technologies
                16.10.1. Company Overview
                16.10.2. Product Portfolio
                16.10.3. SWOT Analysis
                16.10.4. Financial Overview
                16.10.5. Strategic Overview
         16.11. CGI Group
                16.11.1. Company Overview
                16.11.2. Product Portfolio
                16.11.3. SWOT Analysis
                16.11.4. Financial Overview
                16.11.5. Strategic Overview
         16.12. DXC Technology Company
                16.12.1. Company Overview
                16.12.2. Product Portfolio
                16.12.3. SWOT Analysis
                16.12.4. Financial Overview
                16.12.5. Strategic Overview
         16.13. Northrop Grumman Corporation
                16.13.1. Company Overview
                16.13.2. Product Portfolio
                16.13.3. SWOT Analysis
                16.13.4. Financial Overview
                16.13.5. Strategic Overview
         16.14. LexisNexis (A Part of Relx Group)
                16.14.1. Company Overview
                16.14.2. Product Portfolio
                16.14.3. SWOT Analysis
                16.14.4. Financial Overview
                16.14.5. Strategic Overview
         16.15. Pondera Solutions
                16.15.1. Company Overview
                16.15.2. Product Portfolio
                16.15.3. SWOT Analysis
                16.15.4. Financial Overview
                16.15.5. Strategic Overview
17. FutureWise SME key takeaway points for Client

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