A new research document with title ‘Healthcare Fraud Detection Market: Current Analysis and Forecast (2021-2027)’ covering detailed analysis, Competitive landscape, forecast and strategies. The study covers geographic analysis that includes regions like North America (US, Canada, and the Rest of North America), Europe (Germany, France, Italy, Spain, UK, and Rest of Europe), Asia-Pacific (China, Japan, India, Australia, and Rest of APAC), and Rest of World and important players/vendors such as IBM Corporation, Optum, Inc., COTIVITI, INC., McKesson Corporation, Fair Isaac Corporation, SAS Institute Inc., SCIO Inspire, Corp., Conduent, Inc., HCL Technologies Limited, CGI Inc., DXC Technology Company, and Northrop Grumman, etc. The report will help user gain market insights, future trends and growth prospects for forecast period of 2021-2027.
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Healthcare fraud has led to a significant addition of expenses in the healthcare system. As per GAO (General Accounting Office), ‘federal spending on major health care programs to grow from 5.9% of GDP in the fiscal year 2020 to 8.0% of GDP in the fiscal year 2050’. The enormous volume of money involved in the healthcare sector and its size make it an attractive fraud target.
The demand for healthcare fraud detection is increasing on account of rising patients number applying for health insurance, an increase in the number of frauds in pharmacy bills etc. Social media influence on the healthcare industry, speedy acceptance of cloud-based analytical solutions, AI effects in the healthcare services, and increase in the number of fraud identity management software propel the market growth. However, some of the restraints in the market include lack of skilled personnel, reluctance to adopt healthcare fraud analytics paired with high upfront cost of deployment.
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Based on solutions type, the market is divided into descriptive analytics, predictive analytics, and prescriptive analytics. Descriptive analytics holds the major share owing to its high assistance in predictive and prescriptive analytics. For instance, Vidence and NTT DATA announced a partnership to deliver predictive analytics in oncology. This collaboration will make use of a combination of medical imaging scans, clinical and outcomes data to build a predictive model that will improve treatment regimens.
Based on applications, the market is segmented into insurance claims, payment integrity, pharmacy bill and others. The review of insurance claims holds the largest share owing to a high number of people seeking health insurance, an increase in the uptake of the prepayment review model amongst the patients, an increase in fraud activities, and the rising need to control these frauds. For instance, Care Shield insurance announced the launch of Care Shield, which will cover numerous medical expenses and the protection of No Claim Bonus (NCB) benefit from lapsing.
Based on end-user, the market is fragmented into private insurance payers, government agencies, third-party service providers, and others. Government agencies dominates the market on account of rising fraudulent activities coupled with emerging need for data security. For instance, Criminal Division, Fraud Section’s Health Care Fraud (HCF) Unit is comprised of more than 70 prosecutors whose core mission is to prosecute health care fraud-related cases involving patient harm and huge financial loss.
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1 MARKET INTRODUCTION
1.1 Market Definitions
1.2 Objective of the Study
1.3 Limitation
1.4 Stake Holders
1.5 Currency Used in Report
1.6 Scope of the Global Healthcare Fraud Detection Market Study
2 RESEARCH METHODOLOGY OR ASSUMPTION
2.1 Research Methodology for the Global Healthcare Fraud Detection Market
2.1.1 Main Objective of the Global Healthcare Fraud Detection Market
3
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