Healthcare Fraud Detection Market to Expand at a Healthy Growth Rate in the Coming Years

The major factors like large number of fraudulent activities in healthcare; increasing number of patients seeking health insurance; the prepayment review model; growing pressure of fraud, waste, and abuse on healthcare spending; and high returns on investment will help in the growth of the market.

The healthcare fraud detection market is expanding with the emergence of new applications and technologies. Healthcare fraud detection solutions are being used in applications such as insurance claims review, including post-payment review and pre-payment review, payment integrity and other applications including Case Management and identity management.

What the Market Looks Like?

Predicted to grow at a CAGR of 28.9% during the forecast period, the global Healthcare Fraud Detection market is estimated to reach USD 2,242.7 million by 2022. In 2017, North America is expected to dominate the market followed by Europe.

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Based on type, the healthcare fraud detection market is segmented descriptive, predictive, and prescriptive analytics. In 2017, the descriptive analytics segment is expected to account for the largest share of the healthcare fraud detection market. Descriptive analytics forms the base for the effective application of predictive or prescriptive analytics. Thus, descriptive analytics is expected to continue to dominate the healthcare fraud detection market during the forecast period.

Based on application, the healthcare fraud detection market is segmented into insurance claims review, payment integrity, and other applications. The insurance claims review segment is expected to dominate the healthcare fraud detection market with a share in 2017. This segment is also expected to register the highest growth rate during the forecast period, primarily due to the increasing number of patients seeking health insurance, rising number of fraudulent claims, and growing adoption of the prepayment review model.

What Drives the Market?

The growth of the global market for Healthcare Fraud Detection is primarily influenced by the following factors:
• Large Number of Fraudulent Activities in Healthcare
• Increasing Number of Patients Seeking Health Insurance
• Prepayment Review Model
• Growing Pressure of Fraud, Waste, and Abuse on Healthcare Spending
• High Returns on Investment

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Geographical growth scenario of Healthcare Fraud Detection Market

In 2017, North America is expected to dominate the market followed by Europe. The large share of the North American segment is attributed to factors such as increase in the number of people seeking health insurance, increasing cases of healthcare fraud, favorable government initiatives to combat healthcare fraud, rising pressure to reduce healthcare costs, technological advancements, and greater product and service availability in this region.

Leading market players and strategies adopted
The prominent players in the Healthcare Fraud Detection market include IBM (US), Optum (US), SAS (US), McKesson (US), SCIO (US), Verscend (US), Wipro (India), Conduent (US), HCL (India), CGI (Canada), DXC (US), Northrop Grumman (US), LexisNexis (US), and Pondera (US).

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