Healthcare Fraud Analytics Market

Healthcare fraud is problematic to notice and is generally go ignored; consequently, detection of such fraudulent claims is needed, as they increase the burden on society. The use of fraud detection solution qualifies healthcare firms in accounting and auditing by predictive data methodologies. Careful account auditing can reveal suspicious earners and policyholders and detect potential fraudulent cases before it occurs. Through comprehensive market valuation across the main geographies. The global market is segregated on the basis of Application as Pharmacy Billing Misuse, Payment Integrity, Other applications, and Insurance Claims Review. Based on End User the global market is segmented in Third-party service providers, Employers, Public & Government Agencies, and Private Insurance Payers. Based on Delivery Model the global market is segmented in On-demand and On-premise. Based on Solution Type, the global market is segmented in Predictive Analytics, Prescriptive Analytics, and Descriptive Analytics.

The global market report provides geographical analysis covering regions, such as Europe, North America, Asia Pacific, and the Rest of The World. The market for each region is further segmented for major countries including the U.S., Canada, Germany, the U.K., France, Italy, China, India, Japan, Brazil, South Africa, and others.

Competitive Rivalry

CGI Group, DXC Technology Company, Northrop Grumman Corporation, LexisNexis, Pondera Solutions, IBM, Optum, Cotiviti Holdings, Inc., Fair Isaac Corporation, SAS Institute, and others are among the major players in the market. The companies studied in terms of product strategy and various n several growths and expansion strategies to gain a competitive edge in the market. The major players not only follow value chain integration with business operations in multiple stages of the value chain.

The global Healthcare Fraud Analytics market has been segmented as below:

By Application

• Pharmacy Billing Misuse
• Payment Integrity
• Other applications
• Insurance Claims Review

By End-User

• Third-party service providers
• Employers
• Public & Government Agencies
• Private Insurance Payers

By Delivery Model

• On-demand
• On-premise

By Solution Type

• Predictive Analytics
• Prescriptive Analytics
• Descriptive Analytics

By Region

• Europe
• North America
• Asia Pacific
• Rest of The World

By Company

• CGI Group
• DXC Technology Company
• Northrop Grumman Corporation
• LexisNexis
• Pondera Solutions
• IBM
• Optum
• Cotiviti Holdings, Inc.
• Fair Isaac Corporation
• SAS Institute

The report covers the below scope:

• Global market sizes from 2020 to 2026, along with CAGR for 2020-2026
• Market size comparison for 2020 vs 2026, with actual data for 2020, estimates for 2021 and forecast from 2022 to 2026
• Global market trends, covering a comprehensive range of consumer trends & manufacturer trends
• Value chain analysis covering participants from raw material suppliers to the downstream buyer in the market
• Major market opportunities and challenges in forecast timeframe to be focused
• Competitive landscape with analysis of competition pattern, portfolio comparisons, development trends, and strategic management
• Comprehensive company profiles of the key industry players

The years considered for the study are as follows:

• Base year - 2020
• Estimated year - 2021
• Projected year - 2022
• Forecast period - 2022 to 2026

Report Scope:

The global market report scope includes a detailed study covering underlying factors influencing the industry trends. The report covers the analysis of regional and country-level market dynamics. The scope also covers competitive overview providing company market shares along with company profiles for major revenue contributing companies. The report scope includes a detailed competitive outlook covering market shares and profiles key participants in the market share. Major industry players with significant revenue share include CGI Group, DXC Technology Company, Northrop Grumman Corporation, LexisNexis, Pondera Solutions, IBM, Optum, Cotiviti Holdings, Inc., Fair Isaac Corporation, SAS Institute, and others.

Why Buy this Report:

• Gain detailed insights on the Healthcare Fraud Analytics industry trends
• Find a complete analysis of the market status
• Identify the market opportunities and growth segments
• Analyze competitive dynamics by evaluating business segments & product portfolios
• Facilitate strategy planning and industry dynamics to enhance decision making

Target Audience:

The report targeted the existing players in the industry is as follows:

• Market Manufacturers/Service Providers
• Market Wholesale/Traders
• Investment and Financial Institutions

Free and Paid Customization based on the requirement

Report Content

1. Introduction

            1.1 Key Insights

            1.2 Report Overview

            1.3 Markets Covered

            1.4 Stakeholders

2. Research Methodology

            2.1 Research Scope

            2.2 Market Research Process

            2.3 Research Data Analysis

                        2.4.1 Secondary Research

                        2.4.2 Primary Research

                        2.4.3 Models for Estimation

            2.5 Market Size Estimation

                        2.5.1 Bottom-Up Approach - Segmental Market Analysis

                        2.5.2 Top-Down Approach - Parent Market Analysis

3. Executive Summary
4. Market Overview

            4.1 Introduction

                        4.2.1 Drivers

                        4.2.2 Restraints

                        4.2.3 Opportunities

                        4.2.4 Challenges

            4.2 Porter's Five Force Analysis

5. By Application

            5.1 Introduction

            5.2 Pharmacy Billing Misuse

                        5.2.1 Market Overview

                        5.2.2 Market Size and Forecast

            5.3 Payment Integrity

                        5.3.1 Market Overview

                        5.3.2 Market Size and Forecast

            5.4 Other applications

                        5.4.1 Market Overview

                        5.4.2 Market Size and Forecast

            5.5 Insurance Claims Review

                        5.5.1 Market Overview

                        5.5.2 Market Size and Forecast

6. By End-User

            6.1 Introduction

            6.2 Third-party service providers

                        6.2.1 Market Overview

                        6.2.2 Market Size and Forecast

            6.3 Employers

                        6.3.1 Market Overview

                        6.3.2 Market Size and Forecast

            6.4 Public & Government Agencies

                        6.4.1 Market Overview

                        6.4.2 Market Size and Forecast

            6.5 Private Insurance Payers

                        6.5.1 Market Overview

                        6.5.2 Market Size and Forecast

7. By Delivery Model

            7.1 Introduction

            7.2 On-demand

                        7.2.1 Market Overview

                        7.2.2 Market Size and Forecast

            7.3 On-premise

                        7.3.1 Market Overview

                        7.3.2 Market Size and Forecast

8. By Solution Type

            8.1 Introduction

            8.2 Predictive Analytics

                        8.2.1 Market Overview

                        8.2.2 Market Size and Forecast

            8.3 Prescriptive Analytics

                        8.3.1 Market Overview

                        8.3.2 Market Size and Forecast

            8.4 Descriptive Analytics

                        8.4.1 Market Overview

                        8.4.2 Market Size and Forecast

9. By Geography

            9.1 Introduction

            9.2 Europe

                        9.2.1 Europe Market, By Application

                        9.2.2 Europe Market, By End User

                        9.2.3 Europe Market, By Delivery Model

                        9.2.4 Europe Market, By Solution Type

            9.3 North America

                        9.3.1 North America Market, By Application

                        9.3.2 North America Market, By End User

                        9.3.3 North America Market, By Delivery Model

                        9.3.4 North America Market, By Solution Type

            9.4 Asia Pacific

                        9.4.1 Asia Pacific Market, By Application

                        9.4.2 Asia Pacific Market, By End User

                        9.4.3 Asia Pacific Market, By Delivery Model

                        9.4.4 Asia Pacific Market, By Solution Type

            9.5 Rest of The World

                        9.5.1 Rest of The World Market, By Application

                        9.5.2 Rest of The World Market, By End User

                        9.5.3 Rest of The World Market, By Delivery Model

                        9.5.4 Rest of The World Market, By Solution Type

10. Competitive Insights

            10.1 Key Insights

            10.2 Company Market Share Analysis

            10.3 Strategic Outlook

                        10.3.1 Mergers & Acquisitions

                        10.3.2 New Product Development

                        10.3.3 Portfolio/Production Capacity Expansions

                        10.3.4 Joint Ventures, Collaborations, Partnerships & Agreements

                        10.3.5 Others

11. Company Profiles

            11.1 CGI Group

                        11.1.1 Company Overview

                        11.1.2 Product/Service Landscape

                        11.1.3 Financial Overview

                        11.1.4 Recent Developments

            11.2 DXC Technology Company

                        11.2.1 Company Overview

                        11.2.2 Product/Service Landscape

                        11.2.3 Financial Overview

                        11.2.4 Recent Developments

            11.3 Northrop Grumman Corporation

                        11.3.1 Company Overview

                        11.3.2 Product/Service Landscape

                        11.3.3 Financial Overview

                        11.3.4 Recent Developments

            11.4 LexisNexis

                        11.4.1 Company Overview

                        11.4.2 Product/Service Landscape

                        11.4.3 Financial Overview

                        11.4.4 Recent Developments

            11.5 Pondera Solutions

                        11.5.1 Company Overview

                        11.5.2 Product/Service Landscape

                        11.5.3 Financial Overview

                        11.5.4 Recent Developments

            11.6 IBM

                        11.6.1 Company Overview

                        11.6.2 Product/Service Landscape

                        11.6.3 Financial Overview

                        11.6.4 Recent Developments

            11.7 Optum

                        11.7.1 Company Overview

                        11.7.2 Product/Service Landscape

                        11.7.3 Financial Overview

                        11.7.4 Recent Developments

            11.8 Cotiviti Holdings, Inc.

                        11.8.1 Company Overview

                        11.8.2 Product/Service Landscape

                        11.8.3 Financial Overview

                        11.8.4 Recent Developments

            11.9 Fair Isaac Corporation

              &a