Updated Market Developments of Profiled Players In Healthcare Fraud Analytics

The increasing cost burden due to healthcare fraud is proving to be a financial threat to public and government agencies globally. These factors are compelling payer organizations associated with these agencies to adopt analytics solutions to avoid losses incurred due to FWA and improper p

Recent developments are important so as to understand the market trend and growth strategies adopted by players in the reference laboratory market space. The current edition of this report provides updated developments of profiled players from January 2018 – August-2021, indicating the continuation from the previous version. Mergers Acquisitions have been the principal growth strategy adopted by market players between this time period. 


The global healthcare fraud analytics market is projected to reach USD 5.0 billion by 2026, at a CAGR of 26.7% during the forecast period. Market growth can be attributed to a large number of fraudulent activities in healthcare, increasing number of patients seeking health insurance, high returns on investment, and the rising number of pharmacy claims-related frauds. However, the dearth of skilled personnel is expected to restrain the growth of this market. 


Based on solution type, the market is segmented into descriptive, predictive, and prescriptive analytics. The descriptive analytics segment accounted for the largest share of the healthcare fraud analytics market in 2020. Descriptive analytics forms the base for the effective application of predictive or prescriptive analytics, and thus accounts for a large share of this market. 


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On the basis of delivery model, the healthcare fraud analytics market is segmented into on-premise and on-demand delivery models. On-demand delivery models include cloud-based and web-based solutions. In 2020, the on-premise models segment accounted for the largest share of the healthcare fraud analytics market.  


On the basis of application, the market is segmented into insurance claims review, pharmacy billing misuse, payment integrity, and other applications. The insurance claims review segment dominated the healthcare fraud analytics market in 2020. This application segment is expected to register the highest growth during the forecast period.  


The healthcare industry has been witnessing a number of cases of frauds, done by patients, doctors, physicians, and other medical specialists. Many healthcare providers and specialists have been observed to be engaged in fraudulent activities, for the sake of profit. In the healthcare sector, fraudulent activities done by patients include the fraudulent procurement of sickness certificates, prescription fraud, and evasion of medical charges.  


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