The market growth of medical fraud analysis can be attributed to the large amount of fraudulent activity in healthcare, the increasing number of patients seeking health insurance; high return on investment; and the increasing number of fraud related to pharmacy claims. The market is segmented by solution type, delivery model, application and end user. According to the app, the market is divided into insurance claim review, pharmacy billing abuse, payment integrity and other apps. The insurance claims review segment dominates the medical fraud analysis market. With the increasing number of patients seeking health insurance, the increasing number of fraudulent claims, and the increasing popularity of advance payment review models, it is expected to drive growth in this area in the coming years.
This report aims to provide a comprehensive presentation of the global market for Healthcare Fraud Analy, with both quantitative and qualitative analysis, to help readers develop business/growth strategies, assess the market competitive situation, analyze their position in the current marketplace, and make informed business decisions regarding Healthcare Fraud Analy. This report contains market size and forecasts of Healthcare Fraud Analy in global, including the following market information:
Global Healthcare Fraud Analy Market Revenue, 2018-2023, 2024-2035, ($ millions)
Global top five companies in 2022 (%)
The global Healthcare Fraud Analy market was valued at US$ million in 2022 and is projected to reach US$ million by 2035, at a CAGR of % during the forecast period. The influence of COVID-19 and the Russia-Ukraine War were considered while estimating market sizes.
The U.S. Market is Estimated at $ Million in 2022, While China is to reach $ Million.
Descriptive Analytics Segment to Reach $ Million by 2035, with a % CAGR in next six years.
The global key manufacturers of Healthcare Fraud Analy include IBM, Optum, SAS Institute, Change Healthcare, EXL Service Holdings, Cotiviti, Wipro Limited, Conduent and Pondera Solutions, etc. in 2022, the global top five players have a share approximately % in terms of revenue.
We surveyed the Healthcare Fraud Analy companies, and industry experts on this industry, involving the revenue, demand, product type, recent developments and plans, industry trends, drivers, challenges, obstacles, and potential risks.
Total Market by Segment:
Global Healthcare Fraud Analy Market, by Type, 2018-2023, 2024-2035 ($ millions)
Global Healthcare Fraud Analy Market Segment Percentages, by Type, 2022 (%)
Descriptive Analytics
Predictive Analytics
Prescriptive Analytics
Global Healthcare Fraud Analy Market, by Application, 2018-2023, 2024-2035 ($ millions)
Global Healthcare Fraud Analy Market Segment Percentages, by Application, 2022 (%)
Public and Government Agencies
Private Insurance Payers
Third-party Service Providers
Employers
Global Healthcare Fraud Analy Market, By Region and Country, 2018-2023, 2024-2035 ($ Millions)
Global Healthcare Fraud Analy Market Segment Percentages, By Region and Country, 2022 (%)
North America
US
Canada
Mexico
Europe
Germany
France
U.K.
Italy
Russia
Nordic Countries
Benelux
Rest of Europe
Asia
China
Japan
South Korea
Southeast Asia
India
Rest of Asia
South America
Brazil
Argentina
Rest of South America
Middle East & Africa
Turkey
Israel
Saudi Arabia
UAE
Rest of Middle East & Africa
Competitor Analysis
The report also provides analysis of leading market participants including:
Key companies Healthcare Fraud Analy revenues in global market, 2018-2023 (estimated), ($ millions)
Key companies Healthcare Fraud Analy revenues share in global market, 2022 (%)
Further, the report presents profiles of competitors in the market, key players include:
IBM
Optum
SAS Institute
Change Healthcare
EXL Service Holdings
Cotiviti
Wipro Limited
Conduent
Pondera Solutions
LexisNexis
Outline of Major Chapters:
Chapter 1: Introduces the definition of Healthcare Fraud Analy, market overview.
Chapter 2: Global Healthcare Fraud Analy market size in revenue.
Chapter 3: Detailed analysis of Healthcare Fraud Analy company competitive landscape, revenue and market share, latest development plan, merger, and acquisition information, etc.
Chapter 4: Provides the analysis of various market segments by type, covering the market size and development potential of each market segment, to help readers find the blue ocean market in different market segments.
Chapter 5: Provides the analysis of various market segments by application, covering the market size and development potential of each market segment, to help readers find the blue ocean market in different downstream markets.
Chapter 6: Sales of Healthcare Fraud Analy in regional level and country level. It provides a quantitative analysis of the market size and development potential of each region and its main countries and introduces the market development, future development prospects, market space of each country in the world.
Chapter 7: Provides profiles of key players, introducing the basic situation of the main companies in the market in detail, including product sales, revenue, price, gross margin, product introduction, recent development, etc.
Chapter 8: The main points and conclusions of the report.
TABLE OF CONTENTS
1 Introduction to Research & Analysis Reports
1.1 Healthcare Fraud Analy Market Definition
1.2 Market Segments
1.2.1 Market by Type
1.2.2 Market by Application
1.3 Global Healthcare Fraud Analy Market Overview
1.4 Features & Benefits of This Report
1.5 Methodology & Sources of Information
1.5.1 Research Methodology
1.5.2 Research Process
1.5.3 Base Year
1.5.4 Report Assumptions & Caveats
2 Global Healthcare Fraud Analy Overall Market Size
2.1 Global Healthcare Fraud Analy Market Size: 2022 VS 2035
2.2 Global Healthcare Fraud Analy Market Size, Prospects & Forecasts: 2018-2035
2.3 Key Market Trends, Opportunity, Drivers and Restraints
2.3.1 Market Opportunities & Trends
2.3.2 Market Drivers
2.3.3 Market Restraints
3 Company Landscape
3.1 Top Healthcare Fraud Analy Players in Global Market
3.2 Top Global Healthcare Fraud Analy Companies Ranked by Revenue
3.3 Global Healthcare Fraud Analy Revenue by Companies
3.4 Top 3 and Top 5 Healthcare Fraud Analy Companies in Global Market, by Revenue in 2022
3.5 Global Companies Healthcare Fraud Analy Product Type
3.6 Tier 1, Tier 2 and Tier 3 Healthcare Fraud Analy Players in Global Market
3.6.1 List of Global Tier 1 Healthcare Fraud Analy Companies
3.6.2 List of Global Tier 2 and Tier 3 Healthcare Fraud Analy Companies
4 Market Sights by Product
4.1 Overview
4.1.1 By Type - Global Healthcare Fraud Analy Market Size Markets, 2022 & 2035
4.1.2 Descriptive Analytics
4.1.3 Predictive Analytics
4.1.4 Prescriptive Analytics
4.2 By Type - Global Healthcare Fraud Analy Revenue & Forecasts
4.2.1 By Type - Global Healthcare Fraud Analy Revenue, 2018-2023
4.2.2 By Type - Global Healthcare Fraud Analy Revenue, 2024-2035
4.2.3 By Type - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
5 Sights by Application
5.1 Overview
5.1.1 By Application - Global Healthcare Fraud Analy Market Size, 2022 & 2035
5.1.2 Public and Government Agencies
5.1.3 Private Insurance Payers
5.1.4 Third-party Service Providers
5.1.5 Employers
5.2 By Application - Global Healthcare Fraud Analy Revenue & Forecasts
5.2.1 By Application - Global Healthcare Fraud Analy Revenue, 2018-2023
5.2.2 By Application - Global Healthcare Fraud Analy Revenue, 2024-2035
5.2.3 By Application - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
6 Sights by Region
6.1 By Region - Global Healthcare Fraud Analy Market Size, 2022 & 2035
6.2 By Region - Global Healthcare Fraud Analy Revenue & Forecasts
6.2.1 By Region - Global Healthcare Fraud Analy Revenue, 2018-2023
6.2.2 By Region - Global Healthcare Fraud Analy Revenue, 2024-2035
6.2.3 By Region - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
6.3 North America
6.3.1 By Country - North America Healthcare Fraud Analy Revenue, 2018-2035
6.3.2 US Healthcare Fraud Analy Market Size, 2018-2035
6.3.3 Canada Healthcare Fraud Analy Market Size, 2018-2035
6.3.4 Mexico Healthcare Fraud Analy Market Size, 2018-2035
6.4 Europe
6.4.1 By Country - Europe Healthcare Fraud Analy Revenue, 2018-2035
6.4.2 Germany Healthcare Fraud Analy Market Size, 2018-2035
6.4.3 France Healthcare Fraud Analy Market Size, 2018-2035
6.4.4 U.K. Healthcare Fraud Analy Market Size, 2018-2035
6.4.5 Italy Healthcare Fraud Analy Market Size, 2018-2035
6.4.6 Russia Healthcare Fraud Analy Market Size, 2018-2035
6.4.7 Nordic Countries Healthcare Fraud Analy Market Size, 2018-2035
6.4.8 Benelux Healthcare Fraud Analy Market Size, 2018-2035
6.5 Asia
6.5.1 By Region - Asia Healthcare Fraud Analy Revenue, 2018-2035
6.5.2 China Healthcare Fraud Analy Market Size, 2018-2035
6.5.3 Japan Healthcare Fraud Analy Market Size, 2018-2035
6.5.4 South Korea Healthcare Fraud Analy Market Size, 2018-2035
6.5.5 Southeast Asia Healthcare Fraud Analy Market Size, 2018-2035
6.5.6 India Healthcare Fraud Analy Market Size, 2018-2035
6.6 South America
6.6.1 By Country - South America Healthcare Fraud Analy Revenue, 2018-2035
6.6.2 Brazil Healthcare Fraud Analy Market Size, 2018-2035
6.6.3 Argentina Healthcare Fraud Analy Market Size, 2018-2035
6.7 Middle East & Africa
6.7.1 By Country - Middle East & Africa Healthcare Fraud Analy Revenue, 2018-2035
6.7.2 Turkey Healthcare Fraud Analy Market Size, 2018-2035
6.7.3 Israel Healthcare Fraud Analy Market Size, 2018-2035
6.7.4 Saudi Arabia Healthcare Fraud Analy Market Size, 2018-2035
6.7.5 UAE Healthcare Fraud Analy Market Size, 2018-2035
7 Healthcare Fraud Analy Companies Profiles
7.1 IBM
7.1.1 IBM Company Summary
7.1.2 IBM Business Overview
7.1.3 IBM Healthcare Fraud Analy Major Product Offerings
7.1.4 IBM Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.1.5 IBM Key News & Latest Developments
7.2 Optum
7.2.1 Optum Company Summary
7.2.2 Optum Business Overview
7.2.3 Optum Healthcare Fraud Analy Major Product Offerings
7.2.4 Optum Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.2.5 Optum Key News & Latest Developments
7.3 SAS Institute
7.3.1 SAS Institute Company Summary
7.3.2 SAS Institute Business Overview
7.3.3 SAS Institute Healthcare Fraud Analy Major Product Offerings
7.3.4 SAS Institute Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.3.5 SAS Institute Key News & Latest Developments
7.4 Change Healthcare
7.4.1 Change Healthcare Company Summary
7.4.2 Change Healthcare Business Overview
7.4.3 Change Healthcare Healthcare Fraud Analy Major Product Offerings
7.4.4 Change Healthcare Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.4.5 Change Healthcare Key News & Latest Developments
7.5 EXL Service Holdings
7.5.1 EXL Service Holdings Company Summary
7.5.2 EXL Service Holdings Business Overview
7.5.3 EXL Service Holdings Healthcare Fraud Analy Major Product Offerings
7.5.4 EXL Service Holdings Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.5.5 EXL Service Holdings Key News & Latest Developments
7.6 Cotiviti
7.6.1 Cotiviti Company Summary
7.6.2 Cotiviti Business Overview
7.6.3 Cotiviti Healthcare Fraud Analy Major Product Offerings
7.6.4 Cotiviti Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.6.5 Cotiviti Key News & Latest Developments
7.7 Wipro Limited
7.7.1 Wipro Limited Company Summary
7.7.2 Wipro Limited Business Overview
7.7.3 Wipro Limited Healthcare Fraud Analy Major Product Offerings
7.7.4 Wipro Limited Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.7.5 Wipro Limited Key News & Latest Developments
7.8 Conduent
7.8.1 Conduent Company Summary
7.8.2 Conduent Business Overview
7.8.3 Conduent Healthcare Fraud Analy Major Product Offerings
7.8.4 Conduent Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.8.5 Conduent Key News & Latest Developments
7.9 Pondera Solutions
7.9.1 Pondera Solutions Company Summary
7.9.2 Pondera Solutions Business Overview
7.9.3 Pondera Solutions Healthcare Fraud Analy Major Product Offerings
7.9.4 Pondera Solutions Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.9.5 Pondera Solutions Key News & Latest Developments
7.10 LexisNexis
7.10.1 LexisNexis Company Summary
7.10.2 LexisNexis Business Overview
7.10.3 LexisNexis Healthcare Fraud Analy Major Product Offerings
7.10.4 LexisNexis Healthcare Fraud Analy Revenue in Global Market (2018-2023)
7.10.5 LexisNexis Key News & Latest Developments
8 Conclusion
9 Appendix
9.1 Note
9.2 Examples of Clients
9.3 Disclaimer
LIST OF TABLES & FIGURES
List of Tables
Table 1. Healthcare Fraud Analy Market Opportunities & Trends in Global Market
Table 2. Healthcare Fraud Analy Market Drivers in Global Market
Table 3. Healthcare Fraud Analy Market Restraints in Global Market
Table 4. Key Players of Healthcare Fraud Analy in Global Market
Table 5. Top Healthcare Fraud Analy Players in Global Market, Ranking by Revenue (2022)
Table 6. Global Healthcare Fraud Analy Revenue by Companies, (US$, Mn), 2018-2023
Table 7. Global Healthcare Fraud Analy Revenue Share by Companies, 2018-2023
Table 8. Global Companies Healthcare Fraud Analy Product Type
Table 9. List of Global Tier 1 Healthcare Fraud Analy Companies, Revenue (US$, Mn) in 2022 and Market Share
Table 10. List of Global Tier 2 and Tier 3 Healthcare Fraud Analy Companies, Revenue (US$, Mn) in 2022 and Market Share
Table 11. By Type ? Global Healthcare Fraud Analy Revenue, (US$, Mn), 2022 & 2035
Table 12. By Type - Healthcare Fraud Analy Revenue in Global (US$, Mn), 2018-2023
Table 13. By Type - Healthcare Fraud Analy Revenue in Global (US$, Mn), 2024-2035
Table 14. By Application ? Global Healthcare Fraud Analy Revenue, (US$, Mn), 2022 & 2035
Table 15. By Application - Healthcare Fraud Analy Revenue in Global (US$, Mn), 2018-2023
Table 16. By Application - Healthcare Fraud Analy Revenue in Global (US$, Mn), 2024-2035
Table 17. By Region ? Global Healthcare Fraud Analy Revenue, (US$, Mn), 2022 & 2035
Table 18. By Region - Global Healthcare Fraud Analy Revenue (US$, Mn), 2018-2023
Table 19. By Region - Global Healthcare Fraud Analy Revenue (US$, Mn), 2024-2035
Table 20. By Country - North America Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2023
Table 21. By Country - North America Healthcare Fraud Analy Revenue, (US$, Mn), 2024-2035
Table 22. By Country - Europe Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2023
Table 23. By Country - Europe Healthcare Fraud Analy Revenue, (US$, Mn), 2024-2035
Table 24. By Region - Asia Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2023
Table 25. By Region - Asia Healthcare Fraud Analy Revenue, (US$, Mn), 2024-2035
Table 26. By Country - South America Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2023
Table 27. By Country - South America Healthcare Fraud Analy Revenue, (US$, Mn), 2024-2035
Table 28. By Country - Middle East & Africa Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2023
Table 29. By Country - Middle East & Africa Healthcare Fraud Analy Revenue, (US$, Mn), 2024-2035
Table 30. IBM Company Summary
Table 31. IBM Healthcare Fraud Analy Product Offerings
Table 32. IBM Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 33. IBM Key News & Latest Developments
Table 34. Optum Company Summary
Table 35. Optum Healthcare Fraud Analy Product Offerings
Table 36. Optum Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 37. Optum Key News & Latest Developments
Table 38. SAS Institute Company Summary
Table 39. SAS Institute Healthcare Fraud Analy Product Offerings
Table 40. SAS Institute Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 41. SAS Institute Key News & Latest Developments
Table 42. Change Healthcare Company Summary
Table 43. Change Healthcare Healthcare Fraud Analy Product Offerings
Table 44. Change Healthcare Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 45. Change Healthcare Key News & Latest Developments
Table 46. EXL Service Holdings Company Summary
Table 47. EXL Service Holdings Healthcare Fraud Analy Product Offerings
Table 48. EXL Service Holdings Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 49. EXL Service Holdings Key News & Latest Developments
Table 50. Cotiviti Company Summary
Table 51. Cotiviti Healthcare Fraud Analy Product Offerings
Table 52. Cotiviti Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 53. Cotiviti Key News & Latest Developments
Table 54. Wipro Limited Company Summary
Table 55. Wipro Limited Healthcare Fraud Analy Product Offerings
Table 56. Wipro Limited Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 57. Wipro Limited Key News & Latest Developments
Table 58. Conduent Company Summary
Table 59. Conduent Healthcare Fraud Analy Product Offerings
Table 60. Conduent Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 61. Conduent Key News & Latest Developments
Table 62. Pondera Solutions Company Summary
Table 63. Pondera Solutions Healthcare Fraud Analy Product Offerings
Table 64. Pondera Solutions Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 65. Pondera Solutions Key News & Latest Developments
Table 66. LexisNexis Company Summary
Table 67. LexisNexis Healthcare Fraud Analy Product Offerings
Table 68. LexisNexis Healthcare Fraud Analy Revenue (US$, Mn) & (2018-2023)
Table 69. LexisNexis Key News & Latest Developments
List of Figures
Figure 1. Healthcare Fraud Analy Segment by Type in 2022
Figure 2. Healthcare Fraud Analy Segment by Application in 2022
Figure 3. Global Healthcare Fraud Analy Market Overview: 2022
Figure 4. Key Caveats
Figure 5. Global Healthcare Fraud Analy Market Size: 2022 VS 2035 (US$, Mn)
Figure 6. Global Healthcare Fraud Analy Revenue, 2018-2035 (US$, Mn)
Figure 7. The Top 3 and 5 Players Market Share by Healthcare Fraud Analy Revenue in 2022
Figure 8. By Type - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 9. By Application - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 10. By Type - Global Healthcare Fraud Analy Revenue, (US$, Mn), 2022 & 2035
Figure 11. By Type - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 12. By Application - Global Healthcare Fraud Analy Revenue, (US$, Mn), 2022 & 2035
Figure 13. By Application - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 14. By Region - Global Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 15. By Country - North America Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 16. US Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 17. Canada Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 18. Mexico Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 19. By Country - Europe Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 20. Germany Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 21. France Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 22. U.K. Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 23. Italy Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 24. Russia Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 25. Nordic Countries Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 26. Benelux Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 27. By Region - Asia Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 28. China Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 29. Japan Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 30. South Korea Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 31. Southeast Asia Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 32. India Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 33. By Country - South America Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 34. Brazil Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 35. Argentina Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 36. By Country - Middle East & Africa Healthcare Fraud Analy Revenue Market Share, 2018-2035
Figure 37. Turkey Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 38. Israel Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 39. Saudi Arabia Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 40. UAE Healthcare Fraud Analy Revenue, (US$, Mn), 2018-2035
Figure 41. IBM Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 42. Optum Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 43. SAS Institute Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 44. Change Healthcare Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 45. EXL Service Holdings Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 46. Cotiviti Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 47. Wipro Limited Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 48. Conduent Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 49. Pondera Solutions Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
Figure 50. LexisNexis Healthcare Fraud Analy Revenue Year Over Year Growth (US$, Mn) & (2018-2023)
