Data Theft And Fraud In Healthcare Sector Is Driving The Growth Of Healthcare Fraud Detection Market

Global Healthcare Fraud Detection Market: Key Highlights

• According to the new market research report “Healthcare Fraud Detection Market Detection Method (Predictive Analysis, Prescriptive Analysis and Descriptive Analysis), by Product Type (Solution and Service), by End-user (Medical Service Providers, Insurance Service Providers, Diagnostics Laboratories, Government and Others), by Region (Asia Pacific, Europe, Middle East & Africa, South America, North America) — Global Forecast (2020 to 2027)”, the global healthcare fraud detection market is projected to reach till USD 6.14 Billion by 2027 at a CAGR of around 26.29% in the forecast period
• Fraud detection in the healthcare sector is used to detect, analyze and prevent the risk associated with the data manipulation in the medical payment bills, insurance claim & reimbursement, medical records and other false practices to gain higher profit
• Rising use of healthcare fraud detection in the insurance sector to prevent financial losses through manipulation of reimbursement and false insurance claims is fueling the demand for fraud detection in healthcare sector

Global Healthcare Fraud Detection Market: Key Market Dynamics

• Booming healthcare sector, rising demand for better access to healthcare results into increase in fraud in healthcare sector. Rising chronic medical conditions resulting into higher demand for medical treatment escalating the overall financial transaction, drives the risk of healthcare related fraud
• Growing global population, rise in geriatric population with favorable governmental policies for offering better access is driving the demand for health insurance. This, in turn, fuels the demand for healthcare fraud detection
• Increasing penetration of AI in the healthcare fraud detection to eradicate human error and prevent patient information and related financial transaction is creating new opportunities for the market growth
• Lack of skilled technicians for operating healthcare fraud detection solutions and preventing risk of frauds, is acting as a ssskey challenge to the market growth

Global Healthcare Fraud Detection Market: Regional Overview

• North America

The North America healthcare sector is booming at a sustainable pace on the virtue of increasing prevalence of chronic medical conditions and high geriatric population undergoing medical treatment. Favorable support by the US government through Medicade insurance program to provide insurance coverage to the low income facilities for offering better access to healthcare services is driving the market growth. Ongoing efforts to minimize the online healthcare fraud with increasing healthcare expenditure in the Canada, US and other countries is boosting the market growth. As per the Canadian Life and Health Insurance Association, every year around 2–10% of the total healthcare expenditure in North America is accountable to the healthcare fraud.

• Europe

Increasing demand to monitor and prevent overall healthcare expenditure waste is driving the market growth in Europe. As per the data shared by the European Healthcare Fraud & Corruption Network, 15% of the total healthcare expenditure is accredited to healthcare related frauds. Increasing efforts to reduce healthcare frauds in the region and promote safety in healthcare related financial and non-financial transaction is further contributing towards the market growth in Europe.

Global Healthcare Fraud Detection Market: Key Players Overview

• SAS Institute Inc.:

SAS Institute Inc., a manufacturer of analytics software used across banking, communication, education, healthcare, insurance, retail and other end-user industry. The company offers SAS detection and investigation for healthcare for detection and prevent the healthcare fraud, waste and abuse for reducing the overall loss through optimizing payment security.

• Optum, Inc.:

Optum Inc. offers pharmacy related services, and financial healthcare services for organizations and individuals. The company uses its proprietary detection technology in order to detect and prevent aberrant billing patterns. The healthcare fraud detection solution offered by the Optum Pre-pay review solution gives a detail insights payment in the medical procedures in order to prevent loss of expenditure through time-tested predictive analytics.

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