US Healthcare Fraud Analytics Market
The key factor that are responsible for the growth of market include increasing number of healthcare fraudulent cases in the us and growing health insurance industry in the us; however, concerns regarding healthcare fraud analytics may hinder the growth of the healthcare fraud analytics market during the forecast period.
The healthcare industry is susceptible to a wide range of frauds that will lead to financial losses. Healthcare fraud is a large contributor to unnecessary costs and the rise in spending in the US healthcare industry. The financial loss can be declined by deploying artificial intelligence (AI) tools to prevent and detect fraud. AI is capable of analyzing the huge amount of data generated in the healthcare organization and flags the fraud before it starts. The technology is adaptive enough to help tackle fraud at any of its stages. Thus the adoption of AI in healthcare fraud detection is likely to experience the positive outcomes in the coming future.
Strategic insights for the US Healthcare Fraud Analytics provides data-driven analysis of the industry landscape, including current trends, key players, and regional nuances. These insights offer actionable recommendations, enabling readers to differentiate themselves from competitors by identifying untapped segments or developing unique value propositions. Leveraging data analytics, these insights help industry players anticipate the market shifts, whether investors, manufacturers, or other stakeholders. A future-oriented perspective is essential, helping stakeholders anticipate market shifts and position themselves for long-term success in this dynamic region. Ultimately, effective strategic insights empower readers to make informed decisions that drive profitability and achieve their business objectives within the market.
| Report Attribute | Details |
|---|---|
| Market size in 2019 | US$ 517.28 Million |
| Market Size by 2027 | US$ 3,483.12 Million |
| Global CAGR (2020 - 2027) | 27.4% |
| Historical Data | 2017-2018 |
| Forecast period | 2020-2027 |
| Segments Covered |
By Solution
|
| Regions and Countries Covered | United States
|
| Market leaders and key company profiles |
The geographic scope of the US Healthcare Fraud Analytics refers to the specific areas in which a business operates and competes. Understanding local distinctions, such as diverse consumer preferences (e.g., demand for specific plug types or battery backup durations), varying economic conditions, and regulatory environments, is crucial for tailoring strategies to specific markets. Businesses can expand their reach by identifying underserved areas or adapting their offerings to meet local demands. A clear market focus allows for more effective resource allocation, targeted marketing campaigns, and better positioning against local competitors, ultimately driving growth in those targeted areas.
Market Insights
Increasing Number of Healthcare Fraudulent Cases in the US
Most of the healthcare frauds are committed by the small number of fraudulent healthcare providers, and in some cases, by people who are pretending to be legitimate healthcare providers. Unfortunately, the actions of these few deceitful individuals ultimately harms the reputation of the most trusted and respected healthcare professionals. The number of healthcare frauds is increasing in the US. The Department of Justice (DoJ) in January 2019, announced that around US$2.5 billion of the total US$2.8 billion were recovered under the False Claims Act in the US. The most significant monetary recoveries in the year 2018 were from medical device and drug industries. Also, the National Health Care Anti-Fraud Association (NHCAA) estimated that every year, losses due to healthcare frauds are in the tens of billions of dollars. Some government and law enforcement agencies also estimated that healthcare frauds cost around 10% of the total annual health expenditure, which could be around US$ 300 billion. Thus, an increasing number of fraudulent healthcare cases is likely to demand healthcare fraud analytics solutions.
Solution Insights
US healthcare fraud analytics market by product is segmented into predictive analytics, descriptive analytics, and prescriptive analytics. In 2019, the predictive analytics segment held the largest market share of the healthcare fraud analytics market, by product. This segment is also anticipated to dominate the market in 2027 owing analytics detection and identification patterns which are potentially fraudulent and it then develops sets of rules to flag potentially fraudulent claims. Also, the segment is anticipated to witness growth at a significant rate during the forecast period.
Strategic insights for the US Healthcare Fraud Analytics provides data-driven analysis of the industry landscape, including current trends, key players, and regional nuances. These insights offer actionable recommendations, enabling readers to differentiate themselves from competitors by identifying untapped segments or developing unique value propositions. Leveraging data analytics, these insights help industry players anticipate the market shifts, whether investors, manufacturers, or other stakeholders. A future-oriented perspective is essential, helping stakeholders anticipate market shifts and position themselves for long-term success in this dynamic region. Ultimately, effective strategic insights empower readers to make informed decisions that drive profitability and achieve their business objectives within the market.
| Report Attribute | Details |
|---|---|
| Market size in 2019 | US$ 517.28 Million |
| Market Size by 2027 | US$ 3,483.12 Million |
| Global CAGR (2020 - 2027) | 27.4% |
| Historical Data | 2017-2018 |
| Forecast period | 2020-2027 |
| Segments Covered |
By Solution
|
| Regions and Countries Covered | United States
|
| Market leaders and key company profiles |
The geographic scope of the US Healthcare Fraud Analytics refers to the specific areas in which a business operates and competes. Understanding local distinctions, such as diverse consumer preferences (e.g., demand for specific plug types or battery backup durations), varying economic conditions, and regulatory environments, is crucial for tailoring strategies to specific markets. Businesses can expand their reach by identifying underserved areas or adapting their offerings to meet local demands. A clear market focus allows for more effective resource allocation, targeted marketing campaigns, and better positioning against local competitors, ultimately driving growth in those targeted areas.
Mode of Delivery Insights
The US healthcare fraud analytics market by mode of delivery is segmented into on-premise delivery models, cloud-based delivery models. The US healthcare fraud analytics market is dominated by on-premise delivery models segment in 2019 with a considerable market share by mode of delivery. This segment is also predicted to dominate the market in 2027. However, cloud-based delivery models segment is anticipated to witness growth at a significant rate during the forecast period, 2019 to 2027, because it is an extremely manageable alternative which helps in the accessing real-time information.
Application Insights
The US healthcare fraud analytics market by application is segmented into insurance claims review, pharmacy billing misuse, payment integrity, medical identity theft, and other applications. In 2019, the insurance claims review held a largest market share of the healthcare fraud analytics market, by the application. This segment is also predicted to dominate the market in 2027 because it is very common and costly to the healthcare insurance system when fraud is detected and the number of health insurance frauds are increasing every year.
End User Insights
The US healthcare fraud analytics market by end user is segmented into government agencies, private insurance payers, third-party service providers, and employers. In 2019, the government agencies held a largest market share of the healthcare fraud analytics market, by the end user. This segment is also predicted to dominate the market in 2027 because data analytics solutions helped the government to detect and identify the Medicare claims for expensive cancer genetic tests, leading to the charges against 35 people.
Strategic Insights
The companies operating in the market have been implementing various strategies to grow in their corresponding markets; this has, in turn, enabled them to bring various changes in the market. The companies have utilized strategies such as product launches, of their product portfolio and acquisitions for the growth of their organizations.
The List of Companies - US Healthcare Fraud Analytics Market
The US Healthcare Fraud Analytics Market is valued at US$ 517.28 Million in 2019, it is projected to reach US$ 3,483.12 Million by 2027.
As per our report US Healthcare Fraud Analytics Market, the market size is valued at US$ 517.28 Million in 2019, projecting it to reach US$ 3,483.12 Million by 2027. This translates to a CAGR of approximately 27.4% during the forecast period.
The US Healthcare Fraud Analytics Market report typically cover these key segments-
The historic period, base year, and forecast period can vary slightly depending on the specific market research report. However, for the US Healthcare Fraud Analytics Market report:
The US Healthcare Fraud Analytics Market is populated by several key players, each contributing to its growth and innovation. Some of the major players include:
The US Healthcare Fraud Analytics Market report is valuable for diverse stakeholders, including:
Essentially, anyone involved in or considering involvement in the US Healthcare Fraud Analytics Market value chain can benefit from the information contained in a comprehensive market report.
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