This study analyzes the market at the global, regional and corporate levels and deals with the healthcare fraud detection market in a comprehensive manner. In addition to future growth opportunities, the report examines the industry’s overall size. A comprehensive summary of the market and product along with the key applications can be found in the market overview given in the first section. The report spans 2016 to 2024 and offers important details and information on market research. The prediction was focused on current developments in the industry and consumption patterns.
The global healthcare fraud detection market is in the growing healthcare business continuum. The factors driving global healthcare fraud detection market are the rising number of patients opting for health insurance, an increase in the incidents of fraudulent activities, the escalation in healthcare expenditure, and others. However, the unwillingness of the end users to adopt healthcare fraud analytics systems in growing regions are likely to restrain the growth of the global healthcare fraud detection market during the forecast period. Healthcare fraud is a misrepresentation or intentional deception of facts by either healthcare specialists or patients, which can cause in illicit disbursements or advantages.
The Global Healthcare Fraud Detection Market is segmented based on type, component, delivery model, application, end user and region respectively. Based on component, the market has been bifurcated into services and software. By application, the global healthcare fraud detection market has been split into insurance claims review and payment integrity. Because of type healthcare fraud detection market has been separated into scientific analytics, predictive analytics, and prescriptive analytics. Descriptive analytics uses historical data to analyze the changes that have been made. It is helpful for the hospitals to analyze the total revenue produced per patient, month-over-month sales growth, and year-over-year pricing modifications, thus correctly retaining the related records. This information is used to analyze or understand the proceeds cycle during a set period. The prognostic analytics is also termed as a supervised learning technique. This model is built based on the past data which contains fraud or non-fraud indicators along with different elements such as the number of patients, bill amount, treatment characteristics, reporting lags, years of experience of the doctor, and the number of patient visits. Different organizations such as the National Health Care Anti-Fraud Association and the European Healthcare Fraud and Corruption Network (EHFCN) are involved in countering fraud in the healthcare sector. Based on end user the market has been classified as private insurance payers, public/government agencies, and third-party service sources.
The report segment which covers the major regions in terms of production and consumption with respect to the Global Healthcare Fraud Detection Market provides an in-depth analysis of key market indicators. The individual regions that contribute to the overall market performance were covered, in addition to future prospects. This study describes the production, apparent consumption, export and import of Global Healthcare Fraud Detection Market goods in the regions covered.
Geographically the Global Healthcare Fraud Detection Market is split in regions like North & South America, Europe, Asia-Pacific, Middle east and Africa and Rest of the world. The Asia-Pacific region has been labeled as China, India, Japan, and the rest of Asia-Pacific. It retains the third-largest position in the healthcare fraud detection market. Europe held the second-leading market share owing to the high recognition of healthcare fraud detection by the exclusive protection payers. The Europe region is further accounted into Western Europe and Eastern Europe. Western Europe, based on countries has been, segmented into Germany, the UK, France, Italy, Spain, and the rest of Western Europe. The Middle East & Africa is anticipated to witness a astonishing growth owing to the developments in the healthcare services, such as hospitals, clinics, and others. The Americas settled for a market share of 49.97% in 2018. Americas is sub-segmented into North America and South America. North America has been further sub-settled into the US and Canada.
The major companies functioning in the Global Healthcare Fraud Detection Market are concentrating on firming their global ways by entering into untouched markets. The projected onlookers in the Global Healthcare Fraud Detection Market are companies like International Business Machines Corporation (IBM), UNITEDHEALTH group ( UNH ), SAS Institute Inc., FAIR ISAAC Corporation ( FICO ), McKesson Corporation ( MCK ), EXLSERVICE Holdings, Inc. ( EXLS ), DXC Technology Company DXC, LEXISNEXIS, COTIVITI INC. ( COTV ), WIPRO LIMITED, and CGI INC ( GIB ).
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Table of Contents
1 EXECUTIVE SUMMARY
2 MARKET INTRODUCTION
3 RESEARCH METHODOLOGY
4 MARKET DYNAMICS
5 MARKET FACTOR ANALYSIS
6 GLOBAL HEALTHCARE FRAUD DETECTION MARKET, BY TYPE
7 GLOBAL HEALTHCARE FRAUD DETECTION MARKET, BY COMPONENT
8 GLOBAL HEALTHCARE FRAUD DETECTION MARKET, BY DELIVERY MODEL
9 GLOBAL HEALTHCARE FRAUD DETECTION MARKET, BY APPLICATION
10 GLOBAL HEALTHCARE FRAUD DETECTION MARKET, BY END USER
11 GLOBAL HEALTHCARE FRAUD DETECTION MARKET, BY REGION
12 COMPETITIVE LANDSCAPE
13 COMPANY PROFILES
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