The research study on Healthcare Fraud Analytics Market – Global Outlook & Forecast 2023-2028, recently published by Arizton Advisory & Intelligence considers the present scenario of the healthcare fraud analytics market and its market dynamics for 2023−2028. Several market growth enablers, restraints, and trends are covered in detail. The industry’s supply and demand sides are covered in the study. Additionally, it provides profiles and analyses of several other significant businesses active in the sector. Analysts at Arizton evaluated the obtained material and data, gaining insights and understanding of the industry’s workings to provide the data systematically, along with predictions and future insights presented to shareholders based on the past evaluation.
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The healthcare fraud analytics market is a rapidly growing sector in the financial services industry. This growth is driven by the increasing need for healthcare organizations to detect and prevent fraud in their systems.
The healthcare fraud analytics market is highly competitive, with many players vying for a market share. Major players in the market include IBM, LexisNexis Risk Solutions, Optum, SAS Institute, Verisk Analytics, and Wipro. These companies offer a variety of fraud analytics solutions, including data mining, predictive analytics, and ML technologies to identify, detect, and prevent fraud.
Data mining is one of healthcare organizations’ most popular fraud analytics tools. Data mining uses algorithms to analyze large datasets to detect suspicious activity. Predictive analytics uses predictive modeling techniques to identify patterns in the data that may indicate fraudulent activity. ML is used to train algorithms to recognize patterns and detect fraud.
One of the biggest trends in the healthcare fraud analytics market is the increasing use of AI and ML technologies. AI and ML technologies are used to automate the process of fraud detection and prevention. They enable healthcare organizations to process large volumes of data quickly and accurately, thereby reducing the costs associated with manual fraud detection and prevention.
Healthcare Fraud Analytics Market Report Scope
| Report Attributes | Details |
| Market Size (2028) | USD 5.03 Billion |
| Market Size (2022) | USD 1.65 Billion |
| CAGR (2022-2028) | 20.45% |
| Base Year | 2022 |
| Forecast Year | 2023-2028 |
| Market Segmentation | Solution Type, Delivery Mode, Application, End-user, and Geography |
| Geographic Analysis | North America, Europe, APAC, Latin America, and Middle East & Africa |
| Market Dynamics |
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The North America Healthcare Fraud Analytics Market to Reach $2.5 Billion by 2028
North America has the largest share among all the regions and is likely to witness incremental growth in the upcoming years. The US is the major revenue contributor to the North American healthcare fraud analytics market. The presence of a large patient population and better adoption of digital healthcare with the latest advancements in artificial intelligence (AI) is the primary factor for its high market share. The presence of key healthcare IT players is another reason for the high uptake of healthcare fraud analytics in North America. The use of healthcare fraud analytics is becoming increasingly common in the United States and Canada. In the United States, the Department of Health and Human Services (HHS) uses healthcare fraud analytics to identify fraud in Medicare and Medicaid.
Market Trends & Opportunities
Investment in Information & Communication Technology (ICT)
Investment in ICT is a new opportunity for the healthcare fraud analytics market. ICT solutions such as Artificial Intelligence (AI) and Machine Learning (ML) can be used to detect and prevent fraud in the healthcare industry. By leveraging these technologies, healthcare organizations can develop and deploy predictive analytics models to detect suspicious transactions, identity theft, and other fraudulent activities. This can help organizations reduce the risk of fraud, save money, and improve operational efficiency.
AI in Healthcare Fraud Detection
Healthcare is essential in people’s lives, and it must be affordable. The healthcare industry is an intricate system with numerous moving components. It is expanding at an expeditious pace. At the same time, this industry’s fraud is becoming a critical problem. One of the issues is the misuse of the medical insurance systems. Manual detection of fraud in the healthcare industry is a strenuous job. Recently, ML and data mining techniques have been used to detect healthcare fraud automatically.
Advanced Technologies Offer Great Potential to Secure Against Fraud
Advanced technologies offer greater potential to secure against fraud, and this is a new opportunity for the healthcare fraud analytics market. With the increasing sophistication of fraud attempts, the need for advanced analytics tools to detect, prevent, and investigate fraud is becoming more important. Advanced analytics tools can help detect and prevent fraud more quickly and efficiently while providing more detailed insights into fraud patterns. This can help healthcare organizations identify potential areas of fraud and take steps to reduce the risk. In addition, advanced analytics can help healthcare organizations detect and investigate fraud more effectively, which can help reduce the financial losses associated with fraudulent activities.
Market Segmentation
- Solution Type: Descriptive Analytics, Predictive Analytics, and Prescriptive Analytics
- Delivery Mode: On-premises and Cloud-based
- Application: Medical Provider Fraud, Patient Fraud, Prescription Fraud, and General Healthcare Fraud
- End-user: Public Health Insurance Companies, Private Health Insurance Companies, Third-party Service Providers, and Others
- Geography: North America, Europe, APAC, Latin America, and Middle East & Africa
Check out Arizton’s Research Analysis Report: Healthcare Fraud Analytics Market – Global Outlook & Forecast 2023-2028
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