Increased number of patients seeking health insurance is driving the Healthcare Fraud Detection Market
Technavio analyzes that the Healthcare Fraud Detection Market is expected to grow at a CAGR of 11% during 2023 and 2028. During this period, the market is also expected to show a growth of USD 914.3 million.There are various factors that contribute to the growth of the market. The escalating demand for healthcare services, driven by an increasing population and a growing number of insured individuals, has led to a corresponding surge in the need for robust fraud detection solutions in the healthcare industry. The Healthcare Fraud Detection Market is poised for significant growth as stakeholders seek to mitigate financial losses and safeguard the integrity of healthcare systems. Advanced technologies such as machine learning, artificial intelligence, and predictive analytics are increasingly being adopted to identify and prevent fraudulent activities. These solutions enable real-time monitoring of claims processing, automated detection of anomalous patterns, and enhanced investigative capabilities, thereby reducing the risk of revenue loss and ensuring regulatory compliance. Additionally, the market is expected to be fueled by stringent government regulations, growing healthcare expenditures, and the rising prevalence of chronic diseases.
In the realm of healthcare fraud detection, descriptive analytics holds a significant market share, accounting for a substantial portion in 2023. This segment forms the foundation for advanced predictive or prescriptive analytics, as it employs the fundamental principles of data analysis and integrates additional data sources to generate valuable insights. Descriptive analytics is an essential tool for healthcare organizations, enabling them to monitor operational efficiency, identify trends, and evaluate financial performance through financial statements, presentations, and dashboards. By examining historical data, descriptive analytics facilitates the identification of anomalies and potential fraudulent activities within complex healthcare systems, ultimately contributing to the reduction of escalating fraud costs and safeguarding medical services.
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Healthcare Fraud Detection Market Segmentation
Top Performing Companies
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The Healthcare Fraud market addresses the issue of fraudulent activities in the healthcare sector, including false claims, billing schemes, identity theft, and prescription fraud. Offenders cause significant financial losses through various means, necessitating advanced analytics solutions. These solutions employ data analysis techniques such as statistical methods, machine learning, and artificial intelligence for fraud detection. Healthcare fraud analytics encompasses descriptive analytics, predictive analytics, and prescriptive analytics. On-premise and cloud-based solutions cater to insurance claims review, pharmacy billing fraud, payment integrity, and healthcare services fraud. Medicaid Services and Health Insurance are significant targets, with data limitations a challenge. Social media and data analytics play a role in fraud detection, with solutions offering on-demand and on-premise delivery models.
The Healthcare Fraud market encompasses the earnings derived from the sale of healthcare applications, IT systems, monitoring devices, telehealth technologies, and digital health solutions to healthcare providers, clinics, and businesses. According to Technavio, the global healthcare market size is determined by the consolidated revenue generated by manufacturers, suppliers, pharmaceutical companies, healthcare technology providers, biotechnology firms, and life sciences tool and service providers. Factors propelling the expansion of the healthcare technology market include the persistent demand for cost reduction in both developed and emerging economies within the healthcare sector.. Industries are leveraging the products belonging to the market for customer engagement, transactional notifications, and promotional offers.
Technavio Research
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