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Healthcare Fraud Analytics Market worth $24.27 billion by 2030, growing at a CAGR of 19.61% - Exclusive Report by 360iResearch
Healthcare Fraud Analytics Market | 360iResearch
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Healthcare Fraud Analytics encompasses data analysis techniques to detect, prevent, and investigate fraudulent activities within the healthcare system, including inappropriate billing, false claims, and coding errors, using tools and technologies such as machine learning (ML), data mining, and statistical analysis. The necessity for these analytics arises from significant potential cost savings, improved accuracy in fraud detection, and enhanced operational efficiency by automating detection processes. Applications extend to insurance companies, healthcare providers, and regulatory authorities for identifying fraudulent claims, monitoring billing practices, and enforcing legal standards. The end-use scope includes public and private health insurance companies, hospitals, clinics, government agencies, and legal and regulatory bodies. Key growth factors influencing the market include technological advancements in AI, ML, and big data analytics, regulatory pressure for compliance, increased healthcare expenditure, and rising awareness among stakeholders about the benefits of fraud analytics. Opportunities lie in developing AI-driven predictive models, utilizing big data analytics, and implementing blockchain for secure data transactions. However, challenges include data privacy concerns, high initial investment costs, the complexity of integrating diverse healthcare systems, and a skill gap in professionals knowledgeable in both healthcare and analytics. Areas for innovation include interoperability solutions for seamless data exchange, real-time analytics for detecting fraud as it occurs, and behavioral analytics to predict fraudulent activities. The healthcare fraud analytics market is dynamic and evolving, driven by technological advancements and regulatory needs, with continuous opportunities for innovation. To navigate this complex market, stakeholders must proactively adopt new technologies and regulatory-compliant solutions, ensuring enhanced fraud detection and prevention.
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Market Segmentation & Coverage:
This research report categorizes the Healthcare Fraud Analytics Market in order to forecast the revenues and analyze trends in each of following sub-markets:
Based on Solution Type, market is studied across Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics.
Based on Delivery Model, market is studied across On-Demand and On-Premise.
Based on Application, market is studied across Insurance Claims Review, Payment Integrity, and Pharmacy Billing Misuse. The Insurance Claims Review is further studied across Post payment Review and Prepayment Review.
Based on End-User, market is studied across Employers, Private Insurance Payers, Public & Government Agencies, and Third-party service providers.
Based on Region, market is studied across Americas, Asia-Pacific, and Europe, Middle East & Africa. The Americas is further studied across Argentina, Brazil, Canada, Mexico, and United States. The United States is further studied across California, Florida, Illinois, New York, Ohio, Pennsylvania, and Texas. The Asia-Pacific is further studied across Australia, China, India, Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam. The Europe, Middle East & Africa is further studied across Denmark, Egypt, Finland, France, Germany, Israel, Italy, Netherlands, Nigeria, Norway, Poland, Qatar, Russia, Saudi Arabia, South Africa, Spain, Sweden, Switzerland, Turkey, United Arab Emirates, and United Kingdom.
Key Company Profiles:
The report delves into recent significant developments in the Healthcare Fraud Analytics Market, highlighting leading vendors and their innovative profiles. These include Atos SE, CGI Inc., Change Healthcare Inc., Claroty Ltd., Codoxo, Inc., Conduent, Inc., Coviti, Inc., DXC Technology Company, ExlService Holdings, Inc., Fair Isaac Corporation, Fortified Health Security, FraudLens Inc., FRISS, H2O.ai, Inc., HCL Technologies Ltd., Healthcare fraud Shield, Hewlett Packard Enterprise Development LP, Imperva, Inc., Intel Corporation, International Business Machines Corporation, LexisNexis Risk Solutions Group, Mckesson Corporation, Multuplan Corporaton, Northrop Grumman Corporation, OneSpan Inc., OSP Labs, Pondera Solutions, Qlarant Inc., RELX Group Plc, SAS Institute Inc., Sharecare, Inc., United Health Group Incorporated, and Wipro Limited.
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We proudly unveil ThinkMi Query, a cutting-edge AI product designed to transform how businesses interact with the Healthcare Fraud Analytics Market. ThinkMi Query stands out as your premier market intelligence partner, delivering unparalleled insights with the power of artificial intelligence. Whether deciphering market trends or offering actionable intelligence, ThinkMi Query is engineered to provide precise, relevant answers to your most critical business questions. This revolutionary tool is more than just an information source; it's a strategic asset that empowers your decision-making with up-to-the-minute data, ensuring you stay ahead in the fiercely competitive Healthcare Fraud Analytics Market. Embrace the future of market analysis with ThinkMi Query, where informed decisions lead to remarkable growth.
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Key Topics Covered:
1. Preface
2. Research Methodology
3. Executive Summary
4. Market Overview
5. Market Insights
6. Healthcare Fraud Analytics Market, by Solution Type
7. Healthcare Fraud Analytics Market, by Delivery Model
8. Healthcare Fraud Analytics Market, by Application
9. Healthcare Fraud Analytics Market, by End-User
10. Americas Healthcare Fraud Analytics Market
11. Asia-Pacific Healthcare Fraud Analytics Market
12. Europe, Middle East & Africa Healthcare Fraud Analytics Market
13. Competitive Landscape
14. Competitive Portfolio
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About 360iResearch
360iResearch is a market research and business consulting company headquartered in India, with clients and focus markets spanning the globe.
We are a dynamic, nimble company that believes in carving ambitious, purposeful goals and achieving them with the backing of our greatest asset - our people.
Quick on our feet, we have our ear to the ground when it comes to market intelligence and volatility. Our market intelligence is diligent, real-time and tailored to your needs, and arms you with all the insight that empowers strategic decision-making.
Our clientele encompasses about 80% of the Fortune Global 500, and leading consulting and research companies and academic institutions that rely on our expertise in compiling data in niche markets. Our meta-insights are intelligent, impactful and infinite, and translate into actionable data that support your quest for enhanced profitability, tapping into niche markets, and exploring new revenue opportunities.
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