Global Medical Payment Fraud Detection Market Size study, by Type (Descriptive Analytics, Predictive Analytics, Prescriptive Analytics), by Delivery Model (On-premises, Cloud-based), by Component (Software, Services), by Source of Services (In-house, Outsourced), by End-User (Private Insurance Payers, Public/Government Agencies, Third-Party Service Providers) and Regional Forecasts 2020-2027

  • Product Code:
    RP-ID-10347463
  • Published Date:
    2 Jun 2021
  • Region:
    Global
  • Pages:
    200
  • Category:
    Healthcare & Pharmaceuticals
  • Publisher:
    Pub-ID-14

Impact Analysis on the Growth of Market

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Global Medical Payment Fraud Detection Market is valued approximately at USD 1.0 billion in 2019 and is anticipated to grow with a healthy growth rate of more than 25.3% over the forecast period 2020-2027. The healthcare industry is highly regulated, and the cost is monitored closely. Also, the healthcare fraud is the critical issue for the government and there is great need for more effective detection method, which lessen the number of risks and errors in the sector. More often, the emergence of frauds is more frequent in payment of medical bills and other payable cost. Therefore, medical payment fraud detection solutions are used to prevent the healthcare fraud, waste, and abuse. These solutions are completely a falsification or deliberate duplicity of facts by healthcare professionals or patients that can led to unauthorized benefits to hackers. Therefore, the rising pressure of fraud in the healthcare sector, increasing number of patients opting for health insurance, and abuse on healthcare spending are the few factors responsible for the high CAGR of the market during the forecast period. As per the survey of the National Health Care Anti-Fraud Association, there is a surge of 25% increment in healthcare frauds & errors were recorded in 2015, as compared to 6.9% total since 2008, and is reached to almost nearly 52% in 2018. Similarly, as per the Federal Bureau of Investigation estimated that 3% to 10% of healthcare billings are illegal in the United States, with the annual expenditure on healthcare each year. As the incidences of healthcare frauds increases, financial burden also increases on healthcare companies thus, the healthcare groups are opting for medical fraud detection system. This, turn, is expected to impel the growth prospect of medical payment fraud detection market around the world. However, the dearth of skilled professionals and unwillingness to implement these fraud analytic solutions in developing countries are the few factors limiting the market growth over the forecast period of 2020-2027.

The regional analysis of the global Medical Payment Fraud Detection market is considered for the key regions such as Asia Pacific, North America, Europe, Latin America, and Rest of the World. North America is the leading/significant region across the world in terms of market share owing to the intensified penetration of fraud detection solution on the back of growing frauds cases, and the presence of large number of market vendors in the region. Whereas, Asia-Pacific is anticipated to exhibit the highest growth rate / CAGR over the forecast period 2020-2027. Factors such as rising government support and initiatives to reduce the rate of healthcare frauds, followed by the improving healthcare infrastructure in developing countries, such as China and India, would create lucrative growth opportunities for the market growth in the Asia-Pacific region.

Major market player included in this report are:
LexisNexis Risk Solutions
International Business Machines Corporation
Optuminsight
OSP Labs
DXC Technology Company
Unitedhealth Group
SAS Institute
Fair Isaac Corporation
EXL Service Holdings, Inc.
CGI Group

The objective of the study is to define market sizes of different segments & countries in recent years and to forecast the values to the coming eight years. The report is designed to incorporate both qualitative and quantitative aspects of the industry within each of the regions and countries involved in the study. Furthermore, the report also caters the detailed information about the crucial aspects such as driving factors & challenges which will define the future growth of the market. Additionally, the report shall also incorporate available opportunities in micro markets for stakeholders to invest along with the detailed analysis of competitive landscape and product offerings of key players. The detailed segments and sub-segment of the market are explained below:

By Type:
Descriptive Analytics
Predictive Analytics
Prescriptive Analytics

By Delivery Model:
On-premises
Cloud-based

By Component:
Software
Services

By Source of Services:
In-house
Outsourced

By End-User:
Private Insurance Payers
Public/Government Agencies
Third-Party Service Providers

By Region:
North America
U.S.
Canada
Europe
UK
Germany
France
Spain
Italy
ROE

Asia Pacific
China
India
Japan
Australia
South Korea
RoAPAC
Latin America
Brazil
Mexico
Rest of the World

Furthermore, years considered for the study are as follows:

Historical year – 2017, 2018
Base year – 2019
Forecast period – 2020 to 2027

Target Audience of the Global Medical Payment Fraud Detection Market in Market Study:

Key Consulting Companies & Advisors
Large, medium-sized, and small enterprises
Venture capitalists
Value-Added Resellers (VARs)
Third-party knowledge providers
Investment bankers
Investors
Chapter 1. Executive Summary
1.1. Market Snapshot
1.2. Global & Segmental Market Estimates & Forecasts, 2018-2027 (USD Billion)
1.2.1. Medical Payment Fraud Detection Market, by Region, 2018-2027 (USD Billion)
1.2.2. Medical Payment Fraud Detection Market, by Type, 2018-2027 (USD Billion)
1.2.3. Medical Payment Fraud Detection Market, by Delivery Model, 2018-2027 (USD Billion)
1.2.4. Medical Payment Fraud Detection Market, by Component, 2018-2027 (USD Billion)
1.2.5. Medical Payment Fraud Detection Market, by Source of Services, 2018-2027 (USD Billion)
1.2.6. Medical Payment Fraud Detection Market, by End-User, 2018-2027 (USD Billion)
1.3. Key Trends
1.4. Estimation Methodology
1.5. Research Assumption
Chapter 2. Global Medical Payment Fraud Detection Market Definition and Scope
2.1. Objective of the Study
2.2. Market Definition & Scope
2.2.1. Scope of the Study
2.2.2. Industry Evolution
2.3. Years Considered for the Study
2.4. Currency Conversion Rates
Chapter 3. Global Medical Payment Fraud Detection Market Dynamics
3.1. Medical Payment Fraud Detection Market Impact Analysis (2018-2027)
3.1.1. Market Drivers
3.1.2. Market Challenges
3.1.3. Market Opportunities
Chapter 4. Global Medical Payment Fraud Detection Market Industry Analysis
4.1. Porter’s 5 Force Model
4.1.1. Bargaining Power of Suppliers
4.1.2. Bargaining Power of Buyers
4.1.3. Threat of New Entrants
4.1.4. Threat of Substitutes
4.1.5. Competitive Rivalry
4.1.6. Futuristic Approach to Porter’s 5 Force Model (2017-2027)
4.2. PEST Analysis
4.2.1. Political
4.2.2. Economical
4.2.3. Social
4.2.4. Technological
4.3. Investment Adoption Model
4.4. Analyst Recommendation & Conclusion
Chapter 5. Global Medical Payment Fraud Detection Market, by Type
5.1. Market Snapshot
5.2. Global Medical Payment Fraud Detection Market by Type, Performance - Potential Analysis
5.3. Global Medical Payment Fraud Detection Market Estimates & Forecasts by Type 2017-2027 (USD Billion)
5.4. Medical Payment Fraud Detection Market, Sub Segment Analysis
5.4.1. Descriptive Analytics
5.4.2. Predictive Analytics
5.4.3. Prescriptive Analytics
Chapter 6. Global Medical Payment Fraud Detection Market, by Delivery Model
6.1. Market Snapshot
6.2. Global Medical Payment Fraud Detection Market by Delivery Model, Performance - Potential Analysis
6.3. Global Medical Payment Fraud Detection Market Estimates & Forecasts by Delivery Model 2017-2027 (USD Billion)
6.4. Medical Payment Fraud Detection Market, Sub Segment Analysis
6.4.1. On-premises
6.4.2. Cloud-based
Chapter 7. Global Medical Payment Fraud Detection Market, by Component
7.1. Market Snapshot
7.2. Global Medical Payment Fraud Detection Market by Component, Performance - Potential Analysis
7.3. Global Medical Payment Fraud Detection Market Estimates & Forecasts by Component 2017-2027 (USD Billion)
7.4. Medical Payment Fraud Detection Market, Sub Segment Analysis
7.4.1. Software
7.4.2. Services
Chapter 8. Global Medical Payment Fraud Detection Market, by Source of Services
8.1. Market Snapshot
8.2. Global Medical Payment Fraud Detection Market by Source of Services - Potential Analysis
8.3. Global Medical Payment Fraud Detection Market Estimates & Forecasts by Source of Services 2017-2027 (USD Billion)
8.4. Medical Payment Fraud Detection Market, Sub Segment Analysis
8.4.1. In-house
8.4.2. Outsourced
Chapter 9. Global Medical Payment Fraud Detection Market, by End-User
9.1. Market Snapshot
9.2. Global Medical Payment Fraud Detection Market by End-User - Potential Analysis
9.3. Global Medical Payment Fraud Detection Market Estimates & Forecasts by End-User 2017-2027 (USD Billion)
9.4. Medical Payment Fraud Detection Market, Sub Segment Analysis
9.4.1. Private Insurance Payers
9.4.2. Public/Government Agencies
9.4.3. Third-Party Service Providers
Chapter 10. Global Medical Payment Fraud Detection Market, Regional Analysis
10.1. Medical Payment Fraud Detection Market, Regional Market Snapshot
10.2. North America Medical Payment Fraud Detection Market
10.2.1. U.S. Medical Payment Fraud Detection Market
10.2.1.1. Type breakdown estimates & forecasts, 2017-2027
10.2.1.2. Delivery Model breakdown estimates & forecasts, 2017-2027
10.2.1.3. Component breakdown estimates & forecasts, 2017-2027
10.2.1.4. Source of Services breakdown estimates & forecasts, 2017-2027
10.2.1.5. End-User breakdown estimates & forecasts, 2017-2027
10.2.2. Canada Medical Payment Fraud Detection Market
10.3. Europe Medical Payment Fraud Detection Market Snapshot
10.3.1. U.K. Medical Payment Fraud Detection Market
10.3.2. Germany Medical Payment Fraud Detection Market
10.3.3. France Medical Payment Fraud Detection Market
10.3.4. Spain Medical Payment Fraud Detection Market
10.3.5. Italy Medical Payment Fraud Detection Market
10.3.6. Rest of Europe Medical Payment Fraud Detection Market
10.4. Asia-Pacific Medical Payment Fraud Detection Market Snapshot
10.4.1. China Medical Payment Fraud Detection Market
10.4.2. India Medical Payment Fraud Detection Market
10.4.3. Japan Medical Payment Fraud Detection Market
10.4.4. Australia Medical Payment Fraud Detection Market
10.4.5. South Korea Medical Payment Fraud Detection Market
10.4.6. Rest of Asia Pacific Medical Payment Fraud Detection Market
10.5. Latin America Medical Payment Fraud Detection Market Snapshot
10.5.1. Brazil Medical Payment Fraud Detection Market
10.5.2. Mexico Medical Payment Fraud Detection Market
10.6. Rest of The World Medical Payment Fraud Detection Market
Chapter 11. Competitive Intelligence
11.1. Top Market Strategies
11.2. Company Profiles
11.2.1. LexisNexis Risk Solutions
11.2.1.1. Key Information
11.2.1.2. Overview
11.2.1.3. Financial (Subject to Data Availability)
11.2.1.4. Product Summary
11.2.1.5. Recent Developments
11.2.2. International Business Machines Corporation
11.2.3. Optuminsight
11.2.4. OSP Labs
11.2.5. DXC Technology Company
11.2.6. Unitedhealth Group
11.2.7. SAS Institute
11.2.8. Fair Isaac Corporation
11.2.9. EXL Service Holdings, Inc.
11.2.10. CGI Group
Chapter 12. Research Process
12.1. Research Process
12.1.1. Data Mining
12.1.2. Analysis
12.1.3. Market Estimation
12.1.4. Validation
12.1.5. Publishing
12.2. Research Attributes
12.3. Research Assumption
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LexisNexis Risk Solutions
International Business Machines Corporation
Optuminsight
OSP Labs
DXC Technology Company
Unitedhealth Group
SAS Institute
Fair Isaac Corporation
EXL Service Holdings, Inc.
CGI Group
Please enter your personal details below
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