Global Health Care Fraud Analytics Market

Health Care Fraud Analytics Market Size, Share, Growth Analysis, By Application(Insurance claims, payment integrity, pharmacy billing, and others), By Type(Predictive, prescriptive, and descriptive analytics), By Region - Industry Forecast 2025-2032

Report ID: SQMIG35E2032 | Region: Global | Published Date: February, 2024
Pages: 157 | Tables: 64 | Figures: 75

Health Care Fraud Analytics Market Competitive Landscape

The global healthcare fraud analytics market features intense competition among key players striving to enhance healthcare systems' integrity. Established companies like IBM, SAS, and Optum dominate with their advanced analytics solutions, leveraging AI and machine learning to detect and prevent fraudulent activities across medical claims, billing, and patient data. Meanwhile, innovative entrants such as Cotiviti and Pondera offer specialized tools that target evolving fraud schemes. The market's landscape is characterized by continuous technological advancements and collaborations with healthcare providers, as stakeholders increasingly prioritize robust fraud detection to ensure financial security and quality care delivery.

Health Care Fraud Analytics Market Top Player’s Company Profiles

  • IBM Corporation - United States
  • Optum, Inc. (A part of UnitedHealth Group) - United States
  • SAS Institute, Inc. - United States
  • Fair Isaac Corporation (FICO) - United States
  • Conduent, Inc. - United States
  • DXC Technology - United States
  • McKesson Corporation - United States
  • LexisNexis Group - United States
  • Pondera Solutions (Thomson Reuters) - United States
  • Cotiviti Corporation - United States
  • Wipro Limited - India
  • EXL Service Holdings, Inc. - United States
  • HCL Technologies Limited - India
  • McAfee, LLC - United States
  • SAP SE - Germany
  • FICO (Fair Isaac Corporation) - United States
  • BAE Systems Applied Intelligence - United Kingdom
  • SAS Institute Canada - Canada
  • Scio Health Analytics (an EXL Company) - United States
  • NTT Data Corporation - Japan

Health Care Fraud Analytics Market

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Health Care Fraud Analytics Market size was valued at USD 2.02 billion in 2022 and is poised to grow from USD 2.51 billion in 2023 to USD 14.30 billion by 2031, at a CAGR of 24.3% during the forecast period (2024-2031).

The global healthcare fraud analytics market features intense competition among key players striving to enhance healthcare systems' integrity. Established companies like IBM, SAS, and Optum dominate with their advanced analytics solutions, leveraging AI and machine learning to detect and prevent fraudulent activities across medical claims, billing, and patient data. Meanwhile, innovative entrants such as Cotiviti and Pondera offer specialized tools that target evolving fraud schemes. The market's landscape is characterized by continuous technological advancements and collaborations with healthcare providers, as stakeholders increasingly prioritize robust fraud detection to ensure financial security and quality care delivery. 'IBM Corporation - United States', 'Optum, Inc. (A part of UnitedHealth Group) - United States', 'SAS Institute, Inc. - United States', 'Fair Isaac Corporation (FICO) - United States', 'Conduent, Inc. - United States', 'DXC Technology - United States', 'McKesson Corporation - United States', 'LexisNexis Group - United States', 'Pondera Solutions (Thomson Reuters) - United States', 'Cotiviti Corporation - United States', 'Wipro Limited - India', 'EXL Service Holdings, Inc. - United States', 'HCL Technologies Limited - India', 'McAfee, LLC - United States', 'SAP SE - Germany', 'FICO (Fair Isaac Corporation) - United States', 'BAE Systems Applied Intelligence - United Kingdom', 'SAS Institute Canada - Canada', 'Scio Health Analytics (an EXL Company) - United States', 'NTT Data Corporation - Japan'

The increasing prevalence of healthcare fraud and the growing adoption of advanced analytics solutions by healthcare providers and payers to detect and prevent fraudulent activities are propelling the global healthcare fraud analytics market.

In the global healthcare fraud analytics market, key developments include advanced AI and machine learning integration for real-time anomaly detection, predictive modeling, and claims analysis, enhancing fraud identification accuracy. Collaborations between technology providers and healthcare organizations are fostering innovative solutions. Regulatory compliance and data security remain focal points, driving the adoption of robust fraud prevention systems. Additionally, the market sees continuous refinement of algorithms, leveraging big data analytics to improve fraud detection and prevention while minimizing false positives, ultimately safeguarding healthcare resources, and ensuring quality patient care.

The largest market for healthcare fraud analytics has traditionally been North America, particularly the United States. The region's extensive healthcare system, high healthcare spending, and strict regulatory environment have driven the adoption of advanced fraud detection technologies.

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Global Health Care Fraud Analytics Market

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